A 23 year old male presents to the ED after ingestion of an unknown substance. He rapidly decompensated with tachycardia, tachypnea, metabolic acidosis, rigidity and core body temperature of 106 F and very quickly had cardiac arrest. An initial aspirin level was reported as 22 mg/dL. What is the likely culprit?
Dinitrophenol, an uncoupler of oxidative phosphorylation, cross reacts with some salicylates assays resulting in a false positive aspirin level. (Kopec KT et al. Dinitrophenol Fatality Associated with a Falsely Elevated Salicylate Level: A case Report with Verification of laboratory cross reactivity. JMT 2018; 14(4): 323-326)