Malignant hyperpyrexia in an MDMA ("Ecstasy") abuser.

Malignant hyperthermia is a pharmacogenic disease and is manifest by a hypermetabolic crisis with tachycardia, ventricular ectopy, metabolic acidosis, and a rapid rise in body temperature. "Ecstasy", 3,4-methylenedioxymethamphetamine (MDMA), is a semisynthetic amphetamine, the recreational use of which has increased in recent years. Severe reactions to MDMA have been noted in the past, including hyperthermia, rhabdomyolysis and disseminated intravascular coagulation 1. Reports of overdose with MDMA are rare, but hyperthermia and rhabdomyolysis have been reported in association 23,4. Compounds such asMDMA are thought to cause hyperthermia by a central action at 5HT2 receptors 5. However dantrolene, a muscle relaxant acting peripherally, has been used apparently successfully in the treatment of MDMA overdose 4. We report a case of acute perioperative increase in temperature, initially diagnosed and treated as malignant hyperpyrexia, in a patient who later emerged to be an "ecstasy" abuser.