3,4-methylenedioxymethamphetamine (MDMA): An important cause of acute hepatitis

MDMA, i.e. 3,4-methylenedioxymethamphetamine ("Ecstasy"), occasionally produces significant hepatotoxicity in humans. It is characterized by a wide range of variability in clinical expression, ranging from asymptomatic liver injury, as observed by altered liver function tests, to acute hepatic failure. Prognostic factors that may predict the outcome of this condition remain unknown. We report a case of a 19-year-old male who presented deeply jaundiced two weeks after ingestion of two tablets of Ecstasy. The clinical picture, laboratory data, and morphological studies were consistent with acute hepatitis. There was no evidence for a viral, alcoholic, metabolic, or autoimmune etiology of the disease. A mild clinical course with complete recovery after two months was observed. The presence of A11 molecule was confirmed in the patient. The possible association of specific human leukocyte antigen (HLA) phenotypes and MDMA-induced hepatotoxicity needs future evaluation.