Adverse Mercurial Reactions in the Form of Acrodynia and Related Conditions

Ancestry of Pink Disease (Infantile Acrodynia) Identified as a Risk Factor for Autism Spectrum Disorders

“…Upon noticing a similarity of pink disease symptomatology to arsenic and thallium poisoning, American physicians Warkany and Hubbard (1948) undertook a quantitative metal determination of 14 children diagnosed with pink disease and found that 12 of the 14 children had elevated levels of urinary mercury (Hg). A replication study by Warkany and Hubbard (1951) consolidated the finding with Hg levels elevated in 92% of 41 children diagnosed with pink disease in comparison to 15% of controls. Although Hg was used in a wide range of medicinal products at the time, the primary culprit was determined to be teething powders containing calomel (mercurous chloride).…”

Single spies and battalions: the clinical epidemiology of mental disorders

“…Later accounts repeatedly confirmed Setter's reporting as accurate, particularly with respect to the psychiatric features (Warkany & Hubbard, 1951). In retrospect, it is clear that acrodynia, whose mortality has been put as high as 10% (Warkany, 1966) and whose long-term sequelae have never been defined, was from the beginning potentially preventible, being due to the use of mercurial compounds in teething powders, vermifuges and as calomel for a variety of minor complaints.…”

Teen With Rash, Testicular Pain, and Hallucinations

“…9 Patient typically presents with a triad of edematous, painful, erythematous desquamating fingers and toes; neurologic symptoms such as irritability, photophobia, weakness, and paresthesia; and hypertension. 4,10,11 It is classically described as “puffy, pink, painful, paresthetic, perspiring, and peeling hands.” 12 Hypertension associated with acrodynia is due to the inhibition of an enzyme involved in catecholamine breakdown, resulting in accumulation of dopamine, epinephrine, and norepinephrine. 11 Unsurprisingly, catecholamine levels are commonly elevated in these patients, and the level can be tracked as a surrogate marker for therapeutic response.…”