Beyond Rhabdomyolysis: C3 Glomerulopathy in 3,4-Methylenedioxymethamphetamine-Induced Multiorgan Dysfunction
Journal of the American Society of Nephrology October 1, 2025 Solabomi Oyeronke Ojeniyi, Christopher G. Shackleford, Sheetal Koul et al. 1 citation
A 40-year-old man developed life-threatening acute kidney injury after MDMA overdose, requiring dialysis. Kidney biopsy revealed two distinct causes: acute tubular necrosis from severe rhabdomyolysis and C3 glomerulopathy, a rare condition caused by dysregulation of the alternative complement pathway. Complement levels were low during the acute episode but normalized as kidney function recovered, and dialysis was discontinued at discharge. This case suggests that MDMA can trigger complement dysregulation leading to C3 glomerulopathy, which may resolve without specific complement-directed therapies. It underscores the need for broad diagnostic evaluation in drug-associated kidney injury.