Chronic Mercury Intoxication Masquerading as Systemic Disease: A Case Report and Review of the Literature

Abstract

Background: Mercury is a highly toxic environmental metal that exists in three different forms: elemental, inorganic and organic. Intoxication occurs in either occupational or non-occupational settings, mainly after the inhalation of vapour and fumes in work places, laboratories or homes. Chronic mercury toxicity ranges from mild and insignificant to severe and life-threatening. We describe the case of a young male patient who presented with multiple organ dysfunction after chronic mercury exposure. Case presentation: We report the case of 28-year-old male artisanal gold miner who was admitted to hospital for severe neurological impairment associated with inflammatory bowel disease-like symptoms and a skin rash after mercury exposure. Symptomatic treatment and corticosteroid administration assured rapid clinical improvement. Chronic mercury poisoning can masquerade as an autoimmune or systemic inflammatory disease. Conclusion: Physicians should be aware that low exposure to mercury, even from artisanal gold mining, may be harmful to health. Management can be simple without the need for aggressive or invasive therapeutic measures. Larger case series are required in order to establish a clear management plan. LEARNING POINTS• Mercury intoxication has a wide the variety of clinical manifestations that may involve the neurological, gastrointestinal and dermatological systems. • Therefore, it can mimic degenerative neurological conditions, autoimmune diseases, as well as metabolic and mitochondrial disorders.• Once diagnosed, mercury intoxication is easily treated.

Chronic Mercury Poisoning From Daily Cosmetics: Case Report and Brief Literature Review

“…There are multiple mechanisms of toxic action proposed for mercury, including upregulating of vascular endothelial growth factor expression within astrocytes, accumulating of intracellular calcium, affecting cell division, causing immune system disorders and neurodegenerative diseases [2,[4][5][6][7]. The latency of sign and symptom manifestation ranges from months to years.…”

Health Studies in the Context of Artisanal and Small-Scale Mining: A Scoping Review

“…The remaining studies were related to integrated approaches, comprising HBM and health assessment (HA) (n = 68), HA and HRA (n = 9), HBM, HRA and HA (n = 6) and HRA and HBM (n = 1). Of note, three out of four medical case reports were related to both HBM and HA [47][48][49]. Overview of the characteristics of the 176 included health studies.…”

“…Besides chemical pollutants, blood, and urine samples were also analysed for other physiological parameters, such as blood lactate and cyanide [73,74], haematological parameters, and other blood chemistry [47,75], mitochondrial DNA, and other DNA mutations [48,[76][77][78], immunological response to vaccines, and other immune-related proteins [50,79,80], renal and respiratory parameters [75,81], and infectious diseases, such as malaria [82] and HIV [47,83]. Saliva (cortisol salivary) [84], Buccal cells (DNA damage and mutations) [63,77], and stool samples (soil-transmitted helminths and Vibrio cholerae) [85,86] were also reported.…”

Palmoplantar Eruption in a Patient With Mercury Poisoning

“…The most common-allergic contact dermatitis-presents after repeat systemic or topical exposure. 4 Mercury exanthem is an acute systemic contact dermatitis most commonly triggered by mercury vapor inhalation. It manifests as an…”

“…The patient's age at presentation (18 years) was unique, as it is atypical for pink disease. Although the polyarthropathy was attributed to Campylobacter, it is important to note that high levels of mercury exposure also have been associated with polyarthritis, 8 polyneuropathy, 4 and neuromuscular abnormalities on electromyography. 4 Therefore, it is possible that the presence of these symptoms in our patient was either secondary to or compounded by mercury exposure.…”