Diabetic ketoacidosis associated with acute methylone consumption in a 21 year-old male patient

Abstract

Use of methylone has risen recently, traded as a legal substitute of classic drugs, mimicking its effects. Actually it has been banned in European and American markets. The case of ketoacydotic diabetes complicated with the acute consumption of methylone is described in a 21 years’ caucasic insulin dependent male. After the ingestion of 3 capsules during a party, he presents during the dawn of January, 18th of 2012, to a Buenos Aires State suburban Hospital emergency department (Argentina). He refers having experienced dizziness, vomiting and somnolence, with ketotic breath, dehydration, high heart and breath rates and hypertermia. Lab exams showed metabolic acidosis and on the toxicologic analysis methylone level of 0.09 mg/dl was found. Patient was treated in an ICU with fluid reposition, volume restriction, insulin and potassium. Remission occurred after 48 hours. Mechanisms of action suggested include serotoninergic and noradrenergic effects and antidiuretic hormone release, which in term produce dehydration, lypolisis and ketotic bodies raise with acidosis greater than expected for hyperglicemia.

Conclusions. In this case an association between acute use of methylone and ketoacidotic diabetes was found. Epidemiologic surveillance and education about potential risks of methylone use in young people are suggested, especially those who are predisposed to developing ketoacydotic diabetes.