Open AccessDantrolene is not the answer to 2,4-dinitrophenol poisoning: more heated debate
Author(s) -
Jason Van Schoor,
Esha Khanderia,
Andrew Thorniley
Publication year - 2018
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-225323
Subject(s) - dantrolene , medicine , toxicity , rhabdomyolysis , toxicology , intensive care medicine , anesthesia , biology , calcium
There has been a resurgence in the use of 2,4-dinitrophenol, C 6 H 4 N 2 O 5 (DNP) recently as an illegal weight loss drug. We present a case of a healthy 25-year-old girl who took two tablets of DNP, purchased from an overseas online retailer. She was managed with aggressive, invasive cooling measures and 2.5 mg kg -1 dantrolene. Despite this, her temperature continued to rise exponentially to 41.5°C. Cardiac arrest occurred and resuscitation was unsuccessful. To our knowledge, this is the first reported case of the ineffective use of dantrolene in acute DNP poisoning. We review the pathophysiology of DNP toxicity and argue that the use of dantrolene therapy is biochemically implausible, based on poor evidence and likely to be futile. We have contacted the UK National Poisons Information Service (NPIS/TOXBASE) to propose changes to the management of acute DNP toxicity.