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Case Report: A Hyperthermic Death from the Diet Pill DNP

By Jessa Baker, MD; and Mark Baker, MD | on December 15, 2020 | 2 Comments
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Conclusion

DNP is a diet drug that has been banned by the FDA. It has a very narrow therapeutic window, which has resulted in accidental death by hyperthermia of a number of patients, including the young man described in this article. Reversing the hyperthermic effect of DNP is difficult and may be impossible after a certain temperature has been reached. Airway control is compromised by muscle contraction at the cellular level. Death from taking this drug is tragic; those who cared for this patient felt this was a horrific way to die. Efforts to stop distribution of the drug are taking place in some countries and should be increased worldwide.

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Explore This Issue
ACEP Now: Vol 39 – No 12 – December 2020

Dr. Jessa BakerDr. Jessa Baker is a fourth-year resident at the University of California, Los Angeles Department of Emergency Medicine.

Dr. Mark BakerDr. Mark Baker is an emergency medicine physician with the Pali Momi Medical Center Department of Emergency Medicine in Aiea, Hawaii.

Key Points

  • DNP is a diet drug with a very narrow therapeutic window that causes death by hyperthermia.
  • Airway control is compromised by muscle contraction at the cellular level.
  • Reversing the hyperthermic effect of DNP is difficult and may be impossible after a certain temperature has been reached.

References

  1. Busch S. N-Acetylcysteine for weight loss. Livestrong website. Accessed Oct. 22, 2020.
  2. Hamilton A. Industrial poisoning in making coal-tar dyes and dye intermediates. Bulletin of the United States Bureau of Labor Statistics, No. 280. Washington, DC: US Government Printing Office; 1921.
  3. Grundlingh J, Dargan PI, El-Zanfaly M, et al. 2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death. J Med Toxicol. 2011;7(3):205-212.
  4. Provisional peer reviewed toxicity values for 2,4-dinitrophenol (CASRN 51-28-5). United States Environmental Protection Agency website. Accessed Oct. 22, 2020.
  5. Tainter ML, Cutting WC, Stockton AB. Use of dinitrophenol in nutritional disorders: a critical survey of clinical results. Am J Public Health Nations Health. 1934;24(10):1045-1053.
  6. Holborow A, Purnell RM, Wong JF. Beware the yellow slimming pill: fatal 2,4-dinitrophenol overdose. BMJ Case Rep. 2016;2016:bcr2016214689.
  7. Toxicological profile for dinitrophenols, draft for public comment: chapter 2. health effects. Centers for Disease Control and Prevention website. Accessed Oct. 22, 2020.
  8. DNP Guide #2. DNP (Dinitrophenol) Ressource website. Accessed Oct. 22, 2020.
  9. Talk:2,4-Diniotrophenol. Wikipedia website. Accessed Oct. 22, 2020.
  10. Haynes G. The killer weight loss drug DNP is still claiming young lives. Vice website. Accessed Oct. 22, 2020.
  11. FDA targets unlawful internet sales of illegal prescription medicines during International Operation Pangea IX. US Food & Drug Administration website. Accessed Oct. 22, 2020.
  12. Barraclough R, Menzies G. Dinitrophenol (‘DNP’) and the death of Eloise Parry. Six Pump Court Chambers website. Accessed Oct. 22, 2020.
  13. Eloise Parry death: diet pill seller jailed after retrial. BBC News website. Accessed Oct. 22, 2020.
  14. Kopec KT, Kim T, Mowry J, et al. Role of dantrolene in dinitrophenol (DNP) overdose: a continuing question? Am J Emerg Med. 2019;37(6):1216.e1-1216.e2.
  15. Van Schoor J, Khanderia E, Thorniley A. Dantrolene is not the answer to 2,4-dinitrophenol poisoning: more heated debate. BMJ Case Rep. 2018;11(1):e225323.

Pages: 1 2 3 4 | Single Page

Topics: Case PresentationCase ReportsDinitrophenol (DNP)HyperthermiaPoisonToxin

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2 Responses to “Case Report: A Hyperthermic Death from the Diet Pill DNP”

  1. January 10, 2021

    Steven M Winograd, MD FACEP Reply

    Very interesting case. I never had one.

  2. January 10, 2021

    Eric Romig Reply

    A truly scary sounding patient to care for.

    Just wondering if the treatment for Cyanide toxicity (amyl nitrate/ sodium nitrite/ sodium thiosulfate) might be effective since cyanide too causes toxicity by decoupling oxidative phosphorylation.

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