'Fatal 2,4-dinitrophenol poisoning... coming to a hospital near you'.

Abstract

An adult man was brought into the emergency department after deliberate ingestion of dinitrophenol: an agent that uncouples mitochondrial oxidative phosphorylation. The patient rapidly developed a hyper-metabolic state with fever, respiratory failure and died within a few hours after admission. Dinitrophenol is used in the manufacture of dyes, pesticides and explosives. Sub-acute poisoning is associated with weight-loss and the substance had been prescribed for this purpose during the 1930s in the United States before being banned due to serious side effects. Although remaining unlicensed as a drug, dinitrophenol is widely available through mail-order websites and online pharmacies, which promote it as an anti-obesity treatment. This case highlights the need for awareness of possibly increasing rates of accidental poisoning with a growing obesity prevalence and availability of this unlicensed drug through the internet. Additionally, we discuss the use of dantrolene in dinitrophenol poisoning and question whether current Toxbase/UK National Poison Information Service treatment guidelines regarding the indication and dosing of this drug, the only relatively specific treatment in dinitrophenol poisoning presently recommended, could be revised.

• Authors: Claas Siegmueller, Raghunanda Narasimhaiah
• Journal: Emergency medicine journal : EMJ (Emerg Med J) Vol. 27 Issue 8 Pg. 639-40 (Aug 2010) ISSN: 1472-0213 [Electronic] England
• PMID: 20511642 (Publication Type: Case Reports, Journal Article)

Chemical References

• Muscle Relaxants, Central
• Dantrolene
• 2,4-Dinitrophenol
• Calcium Gluconate

Topics

• 2,4-Dinitrophenol (poisoning)
• Adult
• Calcium Gluconate (therapeutic use)
• Dantrolene (therapeutic use)
• Emergency Treatment (methods)
• Fatal Outcome
• Humans
• Hyperkalemia (drug therapy, etiology)
• Infusions, Intravenous
• Male
• Muscle Relaxants, Central (therapeutic use)
• Poisoning (complications, drug therapy)