{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:35:19Z","timestamp":1774067719406,"version":"3.50.1"},"reference-count":15,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Emerg Med J"],"accepted":{"date-parts":[[2014,4,1]]},"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>2,4-Dinitrophenol (DNP) increases energy consumption by uncoupling oxidative phosphorylation. Although not licensed as a medicine, it is sometimes used by \u2018body sculptors\u2019 and for weight loss as a \u2018fat burning\u2019 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2005years), there were 3 during 2007\u20132011 (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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1136\/emermed-2013-203335","type":"journal-article","created":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T06:07:53Z","timestamp":1403590073000},"page":"383-386","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Increasing frequency of severe clinical toxicity after use of 2,4-dinitrophenol in the UK: a report from the National Poisons Information Service"],"prefix":"10.1136","volume":"32","author":[{"given":"Ashraf","family":"Kamour","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gwynnette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lupton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Eddleston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Paul","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Allister","family":"Vale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry Krishna Ruben","family":"Thanacoody","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon Hugh Lynton","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,6,23]]},"reference":[{"key":"2024052700524817000_32.5.383.1","unstructured":"Agency for Toxic Substances and Disease Registry. Toxicological Profile for Dinitrophenol. 1995. http:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp64.pdf (accessed 19 Aug 2013)."},{"key":"2024052700524817000_32.5.383.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yrtph.2007.03.006"},{"key":"2024052700524817000_32.5.383.3","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-011-0162-6"},{"key":"2024052700524817000_32.5.383.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1933.02740440032009"},{"key":"2024052700524817000_32.5.383.5","first-page":"281","article-title":"Pediatric fatality following ingestion of dinitrophenol: postmortem identification of a \"dietary supplement\"","volume":"43","author":"Hsiao","year":"2005","journal-title":"Clin Toxicol"},{"key":"2024052700524817000_32.5.383.6","doi-asserted-by":"publisher","DOI":"10.1042\/bj1110431"},{"key":"2024052700524817000_32.5.383.7","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2008.069401"},{"key":"2024052700524817000_32.5.383.8","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2009.072892"},{"key":"2024052700524817000_32.5.383.9","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep033"},{"key":"2024052700524817000_32.5.383.10","unstructured":"Health Research Authority. 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(accessed 29 Sept 2013)."},{"key":"2024052700524817000_32.5.383.15","unstructured":"Food Standards Agency. Help prevent another DNP death (2013). http:\/\/www.food.gov.uk\/news-updates\/news\/2013\/oct\/dnp#.UvZ4Xfl_uSo (accessed 8 Feb 2014)."}],"container-title":["Emergency Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/emermed-2013-203335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T07:52:58Z","timestamp":1716796378000},"score":1,"resource":{"primary":{"URL":"https:\/\/emj.bmj.com\/lookup\/doi\/10.1136\/emermed-2013-203335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,23]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2015,4,18]]},"published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1136\/emermed-2013-203335"],"URL":"https:\/\/doi.org\/10.1136\/emermed-2013-203335","relation":{},"ISSN":["1472-0205","1472-0213"],"issn-type":[{"value":"1472-0205","type":"print"},{"value":"1472-0213","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,23]]}}}