Death within 44 days of 2,4-dinitrophenol intake

Abstract

We report the case of a 50-year-old obese man (115 kg body mass at 1.77 m height), who started taking 2,4-dinitrophenol (DNP) for weight reduction 44 days before his death. After 43 days of taking DNP, the man showed signs of intoxication with nausea, vomiting, and attacks of sweating. After admission to a hospital where the man concealed his DNP intake, sinus tachycardia, tachypnea, and general unrest were noted. The patient died 9 h after the onset of those symptoms. Upon autopsy, a yellowing of palms and soles was striking. The initially uncertain cause of death could only be clarified by the forensic toxicological examinations and subsequent police investigations. Finally, the man had a total intake of 12.3 g of DNP in 44 days which is relatively high compared to other lethal DNP intoxications.

Analysis of 2,4‐Dinitrophenol in Postmortem Blood and Urine by Gas Chromatography–Mass Spectrometry: Method Development and Validation and Report of Three Fatalities in the United States

“…In one case, information at the admission time in the emergency room was available, and the individual presented several traditional signs of 2,4-DNP intoxication, including elevated body temperature and shortness of breath. The urine collected at the hospital also displayed an abnormal strong and bright yellow color, which can be an indicator of 2,4-DNP presence in the body and it has been reported in other cases in literature in pleural, peritoneal, and pericardial cavity fluids (5), in sweat (3) and in palms/ soles tissue stains (16).…”

“…According to the National Poisons Information Service (NPIS) in England, two deaths were reported in 2017 and three deaths in the first quarter of 2018, with two more in the second quarter (14). Death cases have been reported for bodybuilding or for weight-loss purposes after oral and non-oral exposures (3,(5)(6)(7)15,16). Although 2,4-DNP is not approved in the US for weight-loss purposes, it is available freely for industrial applications and is readily obtained through the Internet, where it is sold as dietary supplement or industrial chemical (2,6).…”

Diet aid or aid to die: an update on 2,4-dinitrophenol (2,4-DNP) use as a weight-loss product

“…Apart from increased basal metabolism and weight loss, the most frequently described symptoms after acute exposure to 2,4-DNP are hyperthermia, nausea, vomiting, confusion, dizziness, headache, agitation, breathing difficulties, back and abdominal pain, tachycardia, diaphoresis, and tachypnoea (Bartlett et al 2010;Grundlingh et al 2011;Siegmueller and Narasimhaiah 2010;Zack et al 2016). Hyperthermia is particularly detrimental to human health and is the limiting factor for 2,4-DNP dose escalation.…”

Would You Use It With a Seal of Approval? Important Attributes of 2,4-Dinitrophenol (2,4-DNP) as a Hypothetical Pharmaceutical Product

“…2,4-DNP is used knowingly and willingly by obese individuals ( 37 ) and those desiring extreme outcomes, such as achieving unnaturally low body fat in bodybuilding ( 38 ), compensating for overeating among bulimia sufferers ( 39 ) or motivated by a rapid and effective weight loss and used 2,4-DNP as shortcut ( 19 , 40 ). The drug is often taken in cycles, and information regarding dosage and personal programs is readily made available by bodybuilders for others in the industry to follow ( 25 ).…”

“…However, 2,4-DNP poses serious health risks to new or naïve users who are not experienced with performance- and image-enhancing drugs or conscientious of dosage, and lack of knowledge on the extent of potential harmful effects ( 19 ). This has contributed to an increasing number of mortalities caused by 2,4-DNP ( 5 , 37 , 39 , 44 – 46 ). It is also important to note that although isolated cases of treatments for 2,4-DNP overdoses have been reported with varying degrees of effectiveness [see ( 47 )], there is to date no established cure or treatment for a 2,4-DNP overdose.…”