Full recovery after severe serotonin syndrome, severe rhabdomyolysis, multi-organ failure and disseminated intravascular coagulopathy from MDMA.
3, 4-methylenedioxymethamphetamine (MDMA), popularly known as ecstasy is a synthetic, psychoactive drug used recreationally for its euphoric and energy increasing effects. MDMA has been linked to several severe adverse effects including the development of serotonin syndrome and sudden death. Individuals of Asian descent have been shown to have a predisposition for these severe adverse effects. We present a case of a young Asian-American male who following MDMA ingestion presented with severe rhabdomyolysis (CK 130,350 UL), multiple organ failure and severe serotonin syndrome with one of the highest recorded temperatures 108.9 °F (42.7 °C) in a survivor of severe serotonin syndrome. The patient initially received supportive care including ventilatory support he eventually needed hemodialysis, but went on to make a full recovery within 3 weeks. This case shows and emphasizes the importance of aggressive supportive care on patient prognosis particularly for patients on the extreme end of the serotonin syndrome.