Acute mercury poisoning

Abstract

SummaryA case of deliberate selj-poisoning with approximately 7 g mercuric chloride (the lethal dose is about 1 g ) is described. The patient died after 6 days despite the use of chelating agents, plasma exchange and intensive supportive therapy. The management of acute mercury toxicity is discussed.

Mercuric Chloride Poisoning Due to Ingestion of a Stool Fixative

“…In two of the stool fixative ingestions (lo), chelator therapy was given within 2 h of ingestion and these patients did not develop renal failure. In one of the stool fixative ingestions (6) and in five other cases where initiation of chelator agents was delayed, the patients developed acute renal failure (5)(6)(7)(8)(9).…”

Full Recovery from a Potentially Lethal Dose of Mercuric Chloride

“…Hemodialysis or other extracorporeal techniques were not used in this case due to limited data on whether any method is particularly efficient in removing toxicologically significant amounts of mercury, either singularly or in combination with chelation [6,28]. Hemodialysis may have some ability to remove mercury in association with dimercaprol and there is some limited evidence of benefit in this context [29,30].…”

Detection of elemental mercury in abdominal wall soft tissue

“…DMSA is superior to previously-used agents including N-acetyl-D,L-penicillamine in terms of efficacy, inhibiting the uptake of methylmercury by human red blood cells and hepatocytes, mobilizing tissue stores of mercury, and increasing its urinary excretion. In Europe and the Middle East, 2,3-dimercaptopropane sulfonate (DMPS) has been used extensively in conjunction with N-acetylcysteine and hemodialysis in a treatment regimen for multiple forms of mercury exposure [2,7,9,10,15]. All cases of mercury granulomas secondary to IV or subcutaneous injection require surgical excision to remove the source of mercury.…”