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Survival Despite Severe Hyperthermia and Multi-Organ System Dysfunction Following Week-Long Use of an MDPV Containing "Stain Remover"
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Synthetic amphetamine and cathinone analogs are sympathomimetic hallucinogens that can cause significant toxicity. Hyperthermia in the setting of sympathomimetic overdose is typically associated with a high mortality. We report a case of neurologically intact survival after extreme hyperthermia in the setting of a sympathomimetic overdose. A 29 year-old male ingested a methylenedioxypyrovalerone "stain remover" and exhibited excited delirium and severe sympathomimetic effects. Multi-organ system toxicity included severe hyperthermia, acidosis, hypoglycemia, intracranial hemorrhage, status epilepticus, myocardial infarction, hypotension, rhabdomyolysis, acute renal failure, acute hepatic injury, and coagulopathy. With aggressive cooling, intravenous fluids, benzodiazepine use, peripheral vasopressors, and hemodialysis, he had a good neurologic outcome at the time of discharge after a 17-day hospital course. Despite a high mortality rate with severe hyperthermia, this case suggests that patients with toxin-induced multi-system organ dysfunctionand associated hyperthermia may recover with early aggressive supportive care.
Keywords
Drugs of Abuse, Hyperthermia, Methylenedioxypyrovalerone.
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- Spiller HA, Ryan ML, Weston RG, Jansen J. Clinical experience with and analytical confirmation of “bath salts” and “legal highs” (synthetic cathinones) in the united states. Clin Toxicol (Phila). 2011;49(6):499-505. doi: 10.3109/15563650.2011.590812 [doi].
- Gowing LR, Henry-Edwards SM, Irvine RJ, Ali RL. The health effects of ecstasy: A literature review. Drug Alcohol Rev. 2002;21(1):53-63. doi: 10.1080/09595230220119363 [doi].
- Kriikku P, Wilhelm L, Schwarz O, Rintatalo J. New designer drug of abuse: 3,4-methylenedioxypyrovalerone (MDPV). findings from apprehended drivers in finland. Forensic Sci Int. 2011;210(1-3):195-200. doi: 10.1016/j.forsciint. 2011.03.015 [doi].
- Coppola M, Mondola R. 3,4-methylenedioxypyrovalerone (MDPV): Chemistry, pharmacology and toxicology of a new designer drug of abuse marketed online. Toxicol Lett. 2012;208(1):12-15. doi: 10.1016/j.toxlet.2011.10.002 [doi].
- Froberg BA, Levine M, Beuhler MC, et al. Acute methylenedioxypyrovalerone toxicity. J Med Toxicol. 2015;11(2):185-194. doi: 10.1007/s13181-014-0446-8 [doi].
- Bonano JS, Glennon RA, De Felice LJ, Banks ML, Negus SS. Abuse-related and abuse-limiting effects of methcathinone and the synthetic “bath salts” cathinone analogs methylenedioxypyrovalerone (MDPV), methylone and mephedrone on intracranial self-stimulation in rats. Psychopharmacology (Berl). 2014;231(1):199-207. doi: 10.1007/s00213-0133223-5 [doi].
- Cameron K, Kolanos R, Vekariya R, De Felice L, Glennon RA. Mephedrone and methylenedioxypyrovalerone (MDPV), major constituents of “bath salts,” produce opposite effects at the human dopamine transporter. Psychopharmacology (Berl). 2013;227(3):493-499. doi: 10.1007/s00213-013-2967-2 [doi].
- Baumann MH, Partilla JS, Lehner KR, et al. Powerful cocainelike actions of 3,4-methylenedioxypyrovalerone (MDPV), a principal constituent of psychoactive ‘bath salts’ products. Neuropsychopharmacology. 2013;38(4):552-562. doi: 10.1038/npp.2012.204 [doi].
- Crandall CG, Vongpatanasin W, Victor RG. Mechanism of cocaine-induced hyperthermia in humans. Ann Intern Med. 2002;136(11):785-791. doi: 200206040-00006 [pii].
- Murray BL, Murphy CM, Beuhler MC. Death following recreational use of designer drug “bath salts” containing 3,4-methylenedioxypyrovalerone (MDPV). J Med Toxicol. 2012;8(1):69-75. doi: 10.1007/s13181-011-0196-9 [doi].
- Borek HA, Holstege CP. Hyperthermia and multiorgan failure after abuse of “bath salts” containing 3,4-methylenedioxypyrovalerone. Ann Emerg Med. 2012;60(1):103-105. doi:10.1016/j.annemergmed.2012.01.005 [doi].
- Young AC, Schwarz ES, Velez LI, Gardner M. Two cases of disseminated intravascular coagulation due to “bath salts” resulting in fatalities, with laboratory confirmation. Am J Emerg Med. 2013;31(2):445.e3-445.e5. doi: 10.1016/j.ajem.2012.05.032 [doi].
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