title: Increasing frequency of severe clinical toxicity after use of 2,4-dinitrophenol in the UK: a report from the National Poisons Information Service.
abstract: OBJECTIVE
  2,4-Dinitrophenol (DNP) increases energy consumption by uncoupling oxidative phosphorylation. Although not licensed as a medicine, it is sometimes used by 'body sculptors' and for weight loss as a 'fat burning' agent. This research was performed to characterise patterns of presentation, clinical features and outcomes of patients reported to the National Poisons Information Service (NPIS) in the UK after exposure to DNP.
  
  
  METHODS
  NPIS telephone enquiry records and user sessions for TOXBASE, the NPIS online information database, related to DNP, were reviewed from 1 January 2007 to 31 December 2013.
  
  
  RESULTS
  Of the 30 separate systemic exposures to DNP reported by telephone to NPIS during the study period (27 males, 3 females, with a median age of 23.5 years), there were 3 during 2007-2011 (inclusive), 5 during 2012 and 22 during 2013. TOXBASE user sessions also increased sharply from 6 in 2011 to 35 in 2012 and 331 in 2013. The modes of exposure reported in telephone enquiries were chronic (n=2), acute (n=12) and subacute (n=16). Commonly reported clinical features were fever (47%), tachycardia (43%), sweating (37%), nausea or vomiting (27%), skin discolouration or rash (23%), breathing difficulties (23%), abdominal pain (23%), agitation (13%) and headache (13%). There were five (17%, 95% CI 6.9% to 34%) fatalities, four involving acute overdose.
  
  
  CONCLUSIONS
  The study indicates a substantial recent increase in clinical presentations with toxicity caused by exposure to DNP in the UK with an associated high mortality. Further steps are needed to warn potential users of the severe and sometimes fatal toxicity that may occur after exposure to this compound.
authors: National Poisons Information Service, Newcastle Unit, Wolfson Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors: Ashraf
authors: A
authors: Kamour
authors: National Poisons Information Service, Newcastle Unit, Wolfson Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors: Nathan
authors: N
authors: George
authors: National Poisons Information Service, Newcastle Unit, Wolfson Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors: David
authors: D
authors: Gwynnette
authors: National Poisons Information Service, Cardiff Unit, University Hospital Llandough, Penarth, Vale of Glamorgan, UK.
authors: Gillian
authors: G
authors: Cooper
authors: National Poisons Information Service, Edinburgh Unit, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors: David
authors: D
authors: Lupton
authors: National Poisons Information Service, Edinburgh Unit, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors: Michael
authors: M
authors: Eddleston
authors: National Poisons Information Service, Cardiff Unit, University Hospital Llandough, Penarth, Vale of Glamorgan, UK.
authors: John Paul
authors: JP
authors: Thompson
authors: National Poisons Information Service, Birmingham Unit, City Hospital, Birmingham, UK.
authors: John Allister
authors: JA
authors: Vale
authors: National Poisons Information Service, Newcastle Unit, Wolfson Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors: Harry Krishna Ruben
authors: HK
authors: Thanacoody
authors: National Poisons Information Service, Newcastle Unit, Wolfson Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors: Simon
authors: S
authors: Hill
authors: National Poisons Information Service, Newcastle Unit, Wolfson Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors: Simon Hugh Lynton
authors: SH
authors: Thomas
mesh_terms: D019297:2,4-Dinitrophenol / Q000009:adverse effects* / Q000506:poisoning; D015746:Abdominal Pain / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced; D002648:Child; D019587:Dietary Supplements / Q000009:adverse effects* / Q000506:poisoning; D004417:Dyspnea / Q000139:chemically induced; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008297:Male; D009325:Nausea / Q000139:chemically induced; D011039:Poison Control Centers; D013546:Sweating / Q000187:drug effects; D013610:Tachycardia / Q000139:chemically induced; D006113:United Kingdom; D014839:Vomiting / Q000139:chemically induced; D055815:Young Adult
chemical_list: D019297:2,4-Dinitrophenol