Two Deaths Attributed to the Use of 2,4-Dinitrophenol

Abstract

We report the cases of two individuals, one in Tacoma, WA, and the second in San Diego, CA, whose deaths were attributed to ingestion of 2,4-dinitrophenol (2,4-DNP). 2,4-DNP has historically been used as a herbicide and fungicide. By uncoupling mitochondrial oxidative phosphorylation, the drug causes a marked increase in fat metabolism that has led to its use to aid weight loss. Both cases reported here involved its use for this purpose. Features common to both cases included markedly elevated body temperature, rapid pulse and respiration, yellow coloring of the viscera at autopsy, history of use of weight loss or body building supplements, and presence of a yellow powder at the decedent's residence. Because of its acidic nature, the drug is not detected in the basic drug fraction of most analytical protocols, but it is recovered in the acid/neutral fraction of biological extracts and can be measured by high-performance liquid chromatography or gas chromatography-mass spectrometry. The concentration of 2,4-DNP in the admission blood samples of the two deaths reported here were 36.1 and 28 mg/L, respectively. Death in both cases was attributed to 2,4-DNP toxicity. Review of information available on the internet suggests that, although banned, 2,4-DNP is still illicitly promoted for weight loss.

Protective properties afforded by pioglitazone against intrastriatal LPS in Sprague–Dawley rats

“…However, in this case UCP2 over-expression may be detrimental to the cell as exacerbated uncoupling could result in mitochondrial impairment. Evidence for overexaggerated uncoupling being detrimental comes from the market removal of the uncoupling diet drug dinitrophenol [26]. Thus, pioglitazone may have attenuated the LPS-induced overexpression of UCP2 to provide protection against over-uncoupling.…”

2,4-Dinitrophenol (DNP): A Weight Loss Agent with Significant Acute Toxicity and Risk of Death

“…These fatalities have been linked to deliberate overdose [4,22,69], accidental toxicity associated with use by bodybuilders or for weight loss [21,28,[72][73][74][75] and accidental occupational exposure [33]. This resurgence in reported fatalities may reflect the increased availability of DNP over the internet, marketed particularly towards bodybuilders.…”

Toxicity of Weight Loss Agents

“…DNP was first criticized in the mid-1930s after multiple cases of cataracts were found to be associated with its use [27]. DNP has not been legally prescribed since being banned in 1938; however, there have been continued case reports of its use [28,29]. With the internet providing access to DNP, there have been increased reports of its use over the last decade [30], including multiple reports of fatalities [28,29,31,32].…”

“…DNP has not been legally prescribed since being banned in 1938; however, there have been continued case reports of its use [28,29]. With the internet providing access to DNP, there have been increased reports of its use over the last decade [30], including multiple reports of fatalities [28,29,31,32]. Particular notoriety was brought to the drug in the 1980s when a Texan physician who privately processed DNP and marketed it as 'Mitcal;' his widespread distribution eventually resulted in a death in 1984 and his conviction in 1986 [30].…”