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‘Fatal 2,4-dinitrophenol poisoning… coming to a hospital near you’
  1. Claas Siegmueller1,
  2. Raghunanda Narasimhaiah2
  1. 1St George's Healthcare NHS Trust, Anaesthetic Department, London, UK
  2. 2Hammersmith Hospital, Imperial College Healthcare NHS Trust, London UK
  1. Correspondence to Dr Claas Siegmueller, St George's Healthcare NHS Trust, Anaesthetic Department, Blackshaw Road, London SW17 0QT, UK; claas.siegmueller{at}yahoo.co.uk

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.

  • 2,4-Dinitrophenol
  • weight loss
  • anti-obesity agents
  • poisoning
  • dantrolene
  • paramedics
  • clincial management
  • paramedics, guidelines
  • poisoning

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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