SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

P62
2,4-DINITROPHENOL (DNP): AN UNUSUAL FATALITY
lain M. Mclntyre*, Ray D. Gary, James L. Sherrard, Dawn R. Parker, Julio Estrada and
Robert E. Whitmore
San Diego County Medical Examiners Office, 5555 Overland Ave., Bldg. 14, San Diego, CA 92123
The decedent was a single 28-year-old male college student who resided with a roommate. His roommate
found the decedent, with a fever, in a tub of ice. The roommate transported him to a local fire department,
from where he was then transported to a local hospital. The decedent was conscious upon admission, but
was soon pronounced dead despite resuscitative efforts. The decedent's roommate informed hospital staff
that the decedent had been taking bodybuilding supplements. Bottles of medications and other materials
found at the scene were brought to the Medical Examiner's Office. These included steroids, ephedrine,
thyroid hormones, a yellow powder and a syringe.
Autopsy showed a young muscular jaundiced Caucasian male with left ventricular hypertrophy of 1.6 cm,
multiorgan congestion, and severe pulmonary edema. The liver was of a soft mottled purple and brown
appearance. There was 150 mL of blood in the stomach, signs of hemorrhagic gastritis, and evidence of
CPR (fractured sternum and anterior rib fractures). Autopsy also showed severe cerebral edema with uncal
herniation and other evidence of medical therapy. Microscopically, the liver showed severe sinusoidal
congestion and subtle centrilobular hepatocyte necrosis. No other significant macroscopic or microscopic
findings were noted.
Routine toxicological screens (alcohols, drugs of abuse, basic drugs, acidic drugs) were conducted on the
antemortem specimens obtained from the admission. The only therapeutic drugs detected were
diphenhydramine (0.13 mgIL) and lidocaine «0.05 mg/L). Specific analyses for steroids (postmortem
urine) and ephedrine (antemortem blood) were negative. Analysis of the yellow powder by gas
chromatography/mass spectrometry identified the powder as 2,4-dinitrophenol (DNP). Subsequent analysis
of the postmortem urine (Toxi-Lab, confirmed by gas chromatography/mass spectrometry), then detected
the presence of DNP. The acid drug screen (HPLe) also detected an unknown compound in the
antemortem blood that was later identified as DNP. DNP was then quantitated by HPLC in the antemortem
blood and in the following postmortem specimens: blood (peripheral), serum (peripheral), liver, urine, bile
and gastric contents.
DNP is primarily used commercially in the production of dyes, wood preservatives, photographic
developers, explosives and pesticides. In the 1930's DNP was used extensively as a diet pill. DNP
effectively increases the basal metabolic rate by inhibiting the synthesis of A TP in the mitochondria. This
action also results in increased sweating, breathing rate, heart rate, weight loss and a marked increase in
body temperature. In 1938 the U.S. Food and Drug Administration banned the use of DNP due to its
harmful effects, which included cataracts, liver damage, and in some cases death.
This is the first report of a fatality associated solely with DNP that describes the detection ofthe compound
in antemortem blood and postmortem tissue concentration distribution.
Keywords: 2,4-Dinitrophenol, postmortem, fatality
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