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Dying to be thin: a dinitrophenol related fatality.
R B McFee1, T R Caraccio, M A McGuigan
1Long Island Regional Poison Control Center, Winthrop University Hospital, 107 Mineola Blvd, Mineola, NY 11501, USA.
Veterinary and Human Toxicology
|October 19, 2004
Summary
2,4-Dinitrophenol (DNP) is a dangerous chemical banned as a diet aid. This case highlights DNP
Area of Science:
- Toxicology
- Pharmacology
- Emergency Medicine
Background:
- 2,4-Dinitrophenol (DNP) is a chemical compound with a history of use as an explosive and later as a metabolic stimulant for weight loss.
- DNP was banned as a dietary aid in 1938 due to concerns regarding hyperpyrexia (dangerously high body temperature).
- Despite its ban, DNP remains accessible globally as a component in some pesticides and is illicitly marketed for weight loss.
Observation:
- A 22-year-old male presented to the Emergency Department (ED) with altered mental status 16 hours after ingesting DNP.
- Upon admission, the patient exhibited diaphoresis (excessive sweating) and fever (oral temperature 102°F), yet was initially lucid.
- The patient rapidly progressed to agitation and delirium, necessitating medical intervention.
Findings:
- Treatment included intravenous midazolam for agitation and mechanical cooling for hyperpyrexia.
- Pancuronium was administered, followed by endotracheal intubation to secure the airway.
- The patient developed bradycardia (slow heart rate) and subsequently asystole (cessation of heart activity), leading to death despite resuscitation.
Implications:
- This case underscores the severe toxicity and potentially fatal outcomes associated with DNP ingestion, even at doses advertised as safe.
- The widespread availability of DNP poses an underrecognized public health risk.
- Further research and public awareness campaigns are crucial to address the dangers of DNP.
