Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia

A case of chronic intoxication by 2,4-dinitrophenol (2,4-DNP) is reported in a 21-year-old bodybuilder, also known as an abuser of anabolic steroids, who died after ingesting 2 grams of this substance after 6 months of repeated consumption. The bodybuilder presented the triad of symptoms – tachycard...

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Main Authors: Coralie Hermetet, Marine Jourdan, Alain Baert, Laurie Gheddar, Alice Ameline, Pascal Kintz, Renaud Bouvet
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1452196/full
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author Coralie Hermetet
Marine Jourdan
Alain Baert
Laurie Gheddar
Alice Ameline
Pascal Kintz
Renaud Bouvet
Renaud Bouvet
author_facet Coralie Hermetet
Marine Jourdan
Alain Baert
Laurie Gheddar
Alice Ameline
Pascal Kintz
Renaud Bouvet
Renaud Bouvet
author_sort Coralie Hermetet
collection DOAJ
description A case of chronic intoxication by 2,4-dinitrophenol (2,4-DNP) is reported in a 21-year-old bodybuilder, also known as an abuser of anabolic steroids, who died after ingesting 2 grams of this substance after 6 months of repeated consumption. The bodybuilder presented the triad of symptoms – tachycardia, tachypnoea, profuse sweating – from 6 months before his death, and was hospitalised for multiple organ failure 4 months before his death. Medical staff attributed this serious episode to his consumption of 2,4-DNP. Although the triad of symptoms persisted, he denied continuing to consume 2,4-DNP during consultations with his general practitioner, who therefore looked into a possible diagnosis of endocrine or tumour disorder. The bodybuilder died of multi-organ failure. The autopsy found diffuse visceral congestion and yellowish colouration of integuments. Toxicology demonstrated not only lethal acute 2,4-DNP intoxication (blood concentration was 88 mg/L), but also chronic intoxication (segmental hair concentrations were 5.1 to 25.5 ng/mg). Different anabolic steroids were also identified in the hair. Continued uncontrolled consumption of 2,4-DNP despite the consequences for his health, combined with an obvious preoccupation with his physical appearance, supported the suspected diagnosis of “muscle dysmorphia”, a psychiatric disorder in which dangerous substances are trivialised. Primary care professionals, the first to come into contact with intoxication cases, should receive training on how to detect and manage cases with symptomology that mimics 2,4-DNP use. A large study evaluating the outcomes of acute intoxication cases if “aggressive” management had been immediately implemented may help us determine the optimal course of action that minimises fatalities.
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publishDate 2024-11-01
publisher Frontiers Media S.A.
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spelling doaj-art-e2a3e78e08e54ae6928584a5f48786fa2025-08-20T02:22:45ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-11-011210.3389/fpubh.2024.14521961452196Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphiaCoralie Hermetet0Marine Jourdan1Alain Baert2Laurie Gheddar3Alice Ameline4Pascal Kintz5Renaud Bouvet6Renaud Bouvet7Department of Legal and Penitentiary Medicine, Rennes University Hospital, Rennes, FranceDepartment of Legal and Penitentiary Medicine, Rennes University Hospital, Rennes, FranceDepartment of Legal and Penitentiary Medicine, Rennes University Hospital, Rennes, FranceInstitute of Forensic Medicine, Strasbourg, FranceInstitute of Forensic Medicine, Strasbourg, FranceInstitute of Forensic Medicine, Strasbourg, FranceDepartment of Legal and Penitentiary Medicine, Rennes University Hospital, Rennes, FranceInstitute of Public Law and Political Science, University of Rennes, Rennes, FranceA case of chronic intoxication by 2,4-dinitrophenol (2,4-DNP) is reported in a 21-year-old bodybuilder, also known as an abuser of anabolic steroids, who died after ingesting 2 grams of this substance after 6 months of repeated consumption. The bodybuilder presented the triad of symptoms – tachycardia, tachypnoea, profuse sweating – from 6 months before his death, and was hospitalised for multiple organ failure 4 months before his death. Medical staff attributed this serious episode to his consumption of 2,4-DNP. Although the triad of symptoms persisted, he denied continuing to consume 2,4-DNP during consultations with his general practitioner, who therefore looked into a possible diagnosis of endocrine or tumour disorder. The bodybuilder died of multi-organ failure. The autopsy found diffuse visceral congestion and yellowish colouration of integuments. Toxicology demonstrated not only lethal acute 2,4-DNP intoxication (blood concentration was 88 mg/L), but also chronic intoxication (segmental hair concentrations were 5.1 to 25.5 ng/mg). Different anabolic steroids were also identified in the hair. Continued uncontrolled consumption of 2,4-DNP despite the consequences for his health, combined with an obvious preoccupation with his physical appearance, supported the suspected diagnosis of “muscle dysmorphia”, a psychiatric disorder in which dangerous substances are trivialised. Primary care professionals, the first to come into contact with intoxication cases, should receive training on how to detect and manage cases with symptomology that mimics 2,4-DNP use. A large study evaluating the outcomes of acute intoxication cases if “aggressive” management had been immediately implemented may help us determine the optimal course of action that minimises fatalities.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1452196/full2,4-dinitrophenolmuscle dysmorphiabodybuildingchronic poisoningaggressive resuscitation therapeuticscase report
spellingShingle Coralie Hermetet
Marine Jourdan
Alain Baert
Laurie Gheddar
Alice Ameline
Pascal Kintz
Renaud Bouvet
Renaud Bouvet
Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
Frontiers in Public Health
2,4-dinitrophenol
muscle dysmorphia
bodybuilding
chronic poisoning
aggressive resuscitation therapeutics
case report
title Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
title_full Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
title_fullStr Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
title_full_unstemmed Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
title_short Case report: Fatal long-term intoxication by 2,4-dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
title_sort case report fatal long term intoxication by 2 4 dinitrophenol and anabolic steroids in a young bodybuilder with muscle dysmorphia
topic 2,4-dinitrophenol
muscle dysmorphia
bodybuilding
chronic poisoning
aggressive resuscitation therapeutics
case report
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1452196/full
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