Fatal hepatorenal failure associated with hydrazine sulfate

Background: The Internet has revolutionized the manner in which patients ob tain information about health care. This technology has also allowed patien ts to obtain directly both prescription and nonprescription therapies. Objective: To report a case of fulminant hepatorenal failure associated wit h the use of hydrazine sulfate, an unregulated alternative remedy for cance r 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 o f liver and kidney tissue. Results: The patient developed hepatic encephalopathy, renal failure, and p rofound coagulopathy. He died after severe gastrointestinal hemorrhage deve loped. Autopsy revealed autolysis of the kidneys and submassive bridging ne crosis 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 con templating the use of hydrazine sulfate.