ECSTASY - A COMMON-CAUSE OF SEVERE ACUTE HEPATOTOXICITY

Background/Aims: Ecstasy is a synthetic amphetamine recently identifie d as a possible cause of acute liver injury This drug is consumed by y oung people and has a marked effect on improving sociability. The exte nt of ecstasy-associated severe hepatic damage is unknown to date. Met hods: The clinical histories of 62 patients with acute liver failure a dmitted to the Intensive Care Liver Unit between January 1994 and Dece mber 1996 mere reviewed to assess the frequency the epidemiological, c linical and histological characteristics and the outcome of ecstasy-in duced severe hepatitis, Results: Over this period of time, five patien ts (8%) were admitted because of ecstasy-induced acute liver failure, representing 31% of the cases with drug hepatotoxicity, Ecstasy was th e second most common cause of liver injury in patients under the age o f 25 years, being 20% in this subset of patients and 36% after ruling out the cases of viral etiology. All the patients had severe liver dis ease of acute onset, with jaundice, high peak of serum transaminases a ctivity, hypoglycemia and low prothrombin activity, but no hepatic enc ephalopathy. Full recovery was observed in all cases from 3 to 12 mont hs. Conclusions: Ecstasy is responsible for a relatively high number o f cases of acute liver failure in young people. Therefore, the use of this drug should be investigated in all patients with severe hepatitis of unclear origin. Efforts must be made to advise young people of the risks of ecstasy consumption.