Fatal hepatorenal failure associated with hydrazine sulfate

Background: The Internet has revolutionized the manner in which patients obtain information about health care. This technology has also allowed patients to obtain directly both prescription and nonprescription therapies. Objective: To report a case of fulminant hepatorenal failure associated with the use of hydrazine sulfate, an unregulated alternative remedy for cancer marketed on the Internet. Design: Case report. Setting: Academic medical center. Patient: A 55-year-old man with maxillary sinus cancer. Intervention: Self-medication with hydrazine sulfate. Measurements: serum liver and renal function tests; histologic evaluation of liver and kidney tissue. Results: The patient developed hepatic encephalopathy, renal failure, and profound coagulopathy. He died after severe gastrointestinal hemorrhage developed. Autopsy revealed autolysis of the kidneys and submassive bridging necrosis of the liver. Conclusion: Fatal hepatorenal failure may occur after the use of hydrazine sulfate. This fatal complication must be considered in anyone taking or contemplating the use of hydrazine sulfate.