Ölümcül Zehirlenme Olgusu: Zayıflama Amaçlı 2-4 Dinitrofenol (DNP) Kullanımı

Year 2024, Volume: 7 Issue: 2, 87 - 90, 29.06.2024

Mustafa Oguz Tuğcan , Zeynep Kekeç

https://doi.org/10.54996/anatolianjem.1385259

Abstract

Amaç: 2,4 Dinitrofenol (DNP®)’nin çok hızlı kilo kaybına neden olduğu bildirilmiş bu nedenle zayıflamak amacıyla kullanılan, daha çok internet siteleri üzerinden satışı yapılan, ölümcül yan etkileri nedeniyle satışı yasaklanmış olan bir ilaçtır. Bu olgu sunumunda, 2,4-dinitrofenol ile ilgili deneyimimizi literatürle paylaşmak amaçlanmıştır.

Olgu: Çalışmamızda beş gündür günde bir adet 200 mg DNP® alan ve son gün iki tablet aldıktan yaklaşık altı saat sonra acil servisimize başvuran 29 yaşındaki hastada tüm destek tedavilerine rağmen başvurudan sekiz saat sonra kardiyopulmoner arrest gelişen, etkili ve yeterli kardiyopulmoner resüsitasyona rağmen eksitus olan olgumuz sunulmuştur.

Sonuç: DNP, küçük dozlarda bile ölümcül olabilen bir maddedir. İlacın internette serbestçe satın alınabilmesi nedeniyle kontrolü zordur ve acilde tanı ve tedavisi kritik öneme sahiptir. Hareketsiz yaşamın ve obezitenin arttığı günümüzde, insanların sağlıklı yaşam ve yasa dışı olarak elde edilebilen zayıflama ilaçlarının riskleri konusunda daha iyi bilgilendirilmesi gerekiyor. Tedaviye yanıtı sınırlı ve ölüm oranı yüksek olan bu ürünlerin internet üzerinden izinsiz satışının engellenmesi ve acil servis hekimleri tarafından zehirlenmelerin erken tanınması DNP zehirlenmelerinde en önemli önleyici tedbir ve tedavide en önemli adımdır.

Keywords

DNP, 2, 4-dinitrofenol, zehirlenme, kilo kaybı, malign hipertermi, acil tıp

A Case of Fatal Poisoning: Use of 2-4 Dinitrophenol for Weight Loss

Abstract

Aim: 2,4-dinitrophenol (DNP®) causes rapid weight loss. Therefore, this drug is used for weight loss, is mostly sold on internet sites, and is banned for sale owing to its deadly side effects. In this case report, we aimed to report a patient who was admitted to our hospital with DNP poisoning.

Case: In the present study, we present a 29-year-old patient who took 200-mg DNP® once a day for 5 days and who applied to our emergency department approximately 6 hours after taking two tablets on the last day. He developed cardiopulmonary arrest 8 hours after admission despite all supportive treatments and died despite effective and adequate cardiopulmonary resuscitation.

Conclusion: DNP poisoning can be fatal even in small doses. It is difficult to control because the drug is freely available on the internet, and urgent diagnosis and treatment is critical. In recent times, where sedentary life and obesity are on the rise, people should be better informed about healthy living and the risks associated with weight loss drugs that can be obtained illegally. Preventing the unauthorized sale of these products, which have a limited response to treatment and a high mortality rate, over the internet and early recognition of poisoning by emergency room physicians is the most important preventive measure in DNP poisonings and the most important step in treatment.

Keywords

DNP, 2, 4-dinitrophenol, poisoning, weight loss, malignant hyperthermia, emergency medicine

Thanks

We/The authors thank Enago – https://www.enago.com.tr/ceviri/ for their assistance in manuscript translation and editing

References

• Colman E. Dinitrophenol and obesity: an early twentieth-century regulatory dilemma. Regul Toxicol Pharmacol. 2007; 48 :115–117. doi: 10.1016/j.yrtph.2007.03.006.
• Rognstad R, Katz J. The effect of 2,4 dinitrophenol on adipose-tissue metabolism. Biochem J. 1969;111:431–444.
• Hoch FL, Hogan FP. Hyperthermia, muscle rigidity, and uncoupling in skeletal muscle mitochondria in rats treated with halothane and 2,4 dinitrophenol. Anaesthesiology. 1973;38:237–243. doi: 10.1097/00000542-197303000-00007.
• Grundlingh J, Dargan PI, El-Zanfaly M, Wood DM. 2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death. Journal of medical toxicology: official journal of the American College of Medical Toxicology. 2011;7(3):205-212. doi:10.1007/S13181-011-0162-6.
• Miranda EJ, McIntyre IM, Parker DR, Gary RD, Logan BK. Two deaths attributed to the use of 2,4-dinitrophenol. Journal of analytical toxicology. 2006;30(3):219-222. doi:10.1093/JAT/30.3.219.
• Sousa D, Carmo H, Roque Bravo R, et al. Diet aid or aid to die: an update on 2,4-dinitrophenol (2,4-DNP) use as a weight-loss product. Archives of Toxicology 2020 94:4. 2020;94(4):1071-1083. doi:10.1007/S00204-020-02675-9.
• Tainter ML. Treatment of acute dinitrophenol poisoning. JAMA. 1935;104:1071–1072.
• Grundlingh J, Dargan PI, El-Zanfaly M, Wood DM. 2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death. J Med Toxicol. 2011 Sep;7(3):205-12. doi: 10.1007/s13181-011-0162-6. PMID: 21739343; PMCID: PMC3550200.
• Poole FE, Haining RB. Sudden death from dinitrophenol poisoning. JAMA. 1934;102:1141–1147.
• Bartlett J, Brunner M, Gough K. Deliberate poisoning with dinitrophenol (DNP): an unlicensed weight loss pill. Emergency medicine journal: EMJ. 2010;27(2):159-160. doi:10.1136/EMJ.2008.069401.
• Kumar S, Barker K, Seger D. Dinitrophenol-induced hyperthermia resolving with dantrolene administration. Clin Toxicol. 2002;40:599–673. doi: 10.1081/CLT-120016859.
• House AA, Ronco C. Extracorporeal blood purification in sepsis and sepsis-related acute kidney injury. Blood purification. 2008;26(1):30-35. doi:10.1159/000110560.