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Eur J Pediatr (2008) 167:10671070 DOI 10.1007/s00431-007-0609-6
SHORT REPORT
Severe Ecstasy poisoning in an 8-month-old infant
Frank Eifinger & Bernhard Roth & Lars Krner &
Markus A. Rothschild
Received: 30 July 2007 / Accepted: 6 September 2007 / Published online: 26 September 2007 # Springer-Verlag 2007
Abstract We report on an 8-month-old male infant who accidentally ingested an Ecstasy tablet (3,4-methylenedioxymetamphetamine, MDMA). Here we discuss, according to the available literature, the treatment, complications, and pharmacokinetics of MDMA intoxication in a young infant. Serum MDMA level 2 hours after ingestion was with 785 ngmL1 above the dose considered lethal for adults (>500 ngmL1). After ingestion the patient showed life-threatening tachycardia of 210 beats min1, hyperthermia of38.9C, seizures, and hypertension of 125/70 mmHg. Under supportive treatment (benzodiazepine, body cooling, rehydration therapy), 6 hours after admission, body temperature as well as the elevated blood pressure and heart beat had returned to normal values. Nine hours after ingestion the serum MDMA level was still 274 ngmL1. The patient made a full clinical recovery and afterwards appeared to be a healthy boy. This case illustrates the need to consider the possibility of accidental Ecstasy ingestion in the differential diagnosis of a child suffering from convulsions with fever.
Keywords MDMA . MDA . Ecstasy . Intoxication . Infant
Abbreviations MDMA Methylenedioxymetamphetamine MDA Methylenedioxyamphetamine
Introduction
Accidental Ecstasy (3,4-methylenedioxymetamphetamine, MDMA) ingestion in children and young infants is a rare life-threatening condition and reports are very limited [10]. Experiences and clinical courses following Ecstasy consumption as well as toxicology data are mainly obtained from adults and adolescents. Here we report on the clinical course in an 8-month-old boy after accidental Ecstasy ingestion. We first describe the pharmacokinetics of MDMA and its metabolite MDA (methylenedioxyamphetamine) in this special case.
Case report
An otherwise healthy 8-month-old male infant of Caucasian origin was brought to our emergency department with a history of generalised seizures. The mother, who was not taking drugs, acknowledged the possibility that the infant might have taken Ecstasy. The ingestion of a pill was not observed. The body weight was 9.3 kg, body length was 67 cm, and an estimated body surface was 0.42 m2. His
airway was clear under spontaneous breathing with 98% peripheral oxygen saturation with 4050 breaths min1.He
had a sinus...