[Young woman dies of water intoxication after taking one tablet of ecstasy. Today's drug panorama calls for increased vigilance in health care].

Increasing numbers of reports demonstrate that low doses of ecstasy (3,4-methylenedioxymethamphetamine--MDMA) may induce life-threatening conditions, such as hyperthermia and water intoxication. These lethal states are rarely due to overdose, and young women seem to be at particular risk. This is a case report of a 20-year-old previously healthy Swedish girl. She died of water intoxication and cerebral edema approximately 24 hours after ingestion of one tablet of "ecstasy" at a rave club in Amsterdam. Clinical findings and laboratory data suggested a syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by MDMA in combination with excessive intake of water. This case illustrates the dire consequences of the present drug abuse panorama, if the increasing need for awareness of potentially lethal complications is not met within emergency health care services.