Case history
Case history
A 20-year-old man presents to the A&E 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 38.8°C (102°F) 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 neurological signs. He experiences a tonic-clonic seizure while in the A&E department, which abates with intravenous diazepam.
Other presentations
Less typical presentations of amfetamine overdose include syndrome of inappropriate antidiuretic hormone with hyponatraemia. Such patients can present with life-threatening cerebral oedema. Another unusual but well-reported presentation is with subarachnoid haemorrhage, 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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