Hypotension, Severe Hyperthermia (42°C), Rhabdomyolysis, and Disseminated Intravascular Coagulation Induced by Lethal Dose of Methamphetamine

Sympathomimetic drug overdose usually results in hypertensive crises, cardiac arrhythmias, rhabdomyolysis, seizures, and metabolic derangements such as hyperglycemia, acidosis, and electrolyte anomalies. Methamphetamine has fast become an increasing problem in the US with an exponential increase in drug-related hospital admissions and an average yearly 29% increase in deaths per year. The recreational dose of methamphetamine is about 5 mg to 60 mg of methamphetamine with lethality reported at around 200 mg. This report presents a fatal case of methamphetamine overdose (>1.5 gms) that presented with hypotension, severe hyperthermia (42.2°C), and rigidity, complicated by rhabdomyolysis, acute renal failure, disseminated intravascular coagulation, and multiorgan failure.