Managing a deliberate 2,4-dinitrophenol overdose: A case report

Abstract

2,4-Dinitrophenol (DNP), previously used as a weight loss drug, was banned owing to its narrow therapeutic index and severe side effects. DNP disrupts mitochondrial oxidative phosphorylation and inhibits adenosine triphosphate synthesis, causing heat production, increased basal metabolic rate and enhanced glycolysis. Despite bans, unregulated online and darknet sales have led to a rise in DNP toxicity cases. We report a case of a young man who survived a deliberate, highly lethal DNP overdose through coordinated team-based care including early aggressive cooling and high-volume mechanical ventilation, crucial in maintaining normothermia and normocapnia. This case adds valuable insights to the literature on DNP toxicity management.