PT  - JOURNAL ARTICLE
AU  - Jason Van Schoor
AU  - Esha Khanderia
AU  - Andrew Thorniley
TI  - Dantrolene is not the answer to 2,4-dinitrophenol poisoning: more heated debate
AID  - 10.1136/bcr-2018-225323
DP  - 2018 Nov 01
TA  - BMJ Case Reports
PG  - e225323
VI  - 11
IP  - 1
4099  - http://casereports.bmj.com/content/11/1/e225323.short
4100  - http://casereports.bmj.com/content/11/1/e225323.full
SO  - BMJ Case Reports2018 Nov 01; 11
AB  - There has been a resurgence in the use of 2,4-dinitrophenol, C6H4N2O5 (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.