A 21-year-old man with severe MDMA (ecstasy) overdose and multi-organ failure—including neurological impairment, hyperpyrexia, rhabdomyolysis, kidney and liver failure, and bleeding—was treated with a CytoSorb adsorber device. His serum MDMA concentration fell from 540 to 140 ng/ml within the first 24 hours, and levels of interleukin 6 and myoglobin also decreased, followed by clinical improvement and full recovery. In vitro, the device removed MDMA to undetectable levels. The authors suggest early use of the adsorber may help manage severe MDMA intoxication, though they cannot prove the clinical improvement was directly due to MDMA removal or to effects on rhabdomyolysis, hyperinflammation, or liver failure.
CytoSorb hemoadsorption effectively removes 3,4-methylenedioxymethamphetamine (MDMA) in vitro, but its clinical removal in a reported case may have been minimal because therapy started late and removal is concentration dependent. The device was very effective for treating rhabdomyolysis and hyperinflammation in that patient. Whether the case confirms in vivo MDMA removal by CytoSorb is debatable. The potential of CytoSorb to help critically ill patients requires further study.