Case history
Case history
A 20-year-old man presents to the emergency department in an agitated state. He says that he purchased a tablet for $10 at a dance club and was told it was "E." Vital signs are rectal temperature of 102°F (38.8°C) and blood pressure 125/80 mmHg. On examination he is found to have tachycardia, and volume depletion with loss of skin turgor and a dry mouth. There is no ocular clonus, hyperreflexia, or rigidity, and no focal neurologic signs. He experiences a tonic-clonic seizure while in the emergency department, which abates with intravenous diazepam.
Other presentations
Less typical presentations of amphetamine overdose include syndrome of inappropriate antidiuretic hormone with hyponatremia. Such patients can present with life-threatening cerebral edema. Another unusual but well-reported presentation is with subarachnoid hemorrhage, which is thought to be directly related to sympathetic overstimulation and hypertension.[2][3] Hyperthermia may also lead to a clinical picture similar to that of severe heatstroke: rhabdomyolysis, metabolic acidosis, renal failure, disseminated intravascular coagulation with risk of microinfarcts, and acute respiratory distress syndrome.[4][5][6][7][8][9]
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