Infantile Renal Tubular Acidosis Due to Mercury Poisoning

Husband, Peter; McKellar, William

doi:10.1136/adc.45.240.264

Cited by 13 publications

(7 citation statements)

References 20 publications

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“…However, the PO 2 and SpO 2 levels were found to be higher at the end of the study in the LTG than in the STG, indicating some form of adaptive response to the long-term exposure to elemental mercury vapor, leading to improved oxygen saturation of the blood. The ABGs results indicate that rats exposed to elemental vapor inhalation suffered a significant degree of respiratory acidosis, in contrast to previously established evidence in the literature leaning predominantly toward metabolic acidosis with mercury poisoning in both animals [ 37 ] and humans, predominantly children [ 38 , 39 ]. The higher incidence of acidosis in the pediatric age group than in adults exposed to elemental mercury in the literature can be explained by the difference in body weight and physiological maturity, which results in a much lower degree of exposure being necessary to bring mercury to highly toxic and potentially fatal concentrations in the blood and tissues.…”

Section: Discussioncontrasting

confidence: 91%

Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukin-1 Expression in Pulmonary Tissues of Rats

Raffee

Alawneh

Alassaf

et al. 2021

The Scientific World Journal

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We investigated the effects of elemental mercury vapor inhalation on arterial blood gases (ABGs), lung histology, and interleukin-1 (IL-1) expression in pulmonary tissues in rats. A total of 42 Sprague Dawley rats were divided randomly into three groups. Rats in the first group were used as the control (CG). A short-term group (STG) and a long-term group (LTG) were exposed to 500 μg/m3 of mercury vapor 2 hrs/day for 21 days and 65 days, respectively. After exposure periods were completed, arterial blood samples were obtained, and ABGs were measured. Lung tissue sections were prepared for histology evaluation and immune-stained to detect IL-1 expression. There was a significant decrease in body weight in both STG (15%) and LTG (22%) compared with the CG. In the LTG, six out of 14 (43%) rats died, including two males and four females, while none of the rats in the STG died during the experiment. In both STG and LTG, a significant acid-base imbalance was characterized by a significant decrease in blood pH values and a significant increase in PCO2 values. Both PO2 and SpO2 blood values were significantly decreased in the STG and LTG, while no changes were observed in HCO3 values in all groups. Histological evaluation of lung tissues revealed severe lesions characterized by pulmonary emphysema and inflammatory cellular infiltrate. IL-1 expression in lung tissues was not significantly different between exposed rats and control subjects. These results indicate significant alterations in blood acid-base status characterized by severe respiratory acidosis with hypoxemia and no evidence of compensatory alkalosis in rats after exposure to short- and long-term elementary mercury vapor.

show abstract

Section: Discussioncontrasting

confidence: 91%

Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukin-1 Expression in Pulmonary Tissues of Rats

Raffee

Alawneh

Alassaf

et al. 2021

The Scientific World Journal

View full text Add to dashboard Cite

show abstract

“…However, the PO2 and SPO2 levels were found to be higher at the end of the study in the LTG than in the STG, indicating some form of adaptive response to the long-term exposure to elemental mercury vapor, leading to improved oxygen saturation of the blood. The ABG's results indicate that rats exposed to elemental vapor inhalation suffered a signi cant degree of respiratory acidosis, in contrast to previously established evidence in the literature leaning predominantly towards metabolic acidosis with mercury poisoning in both animals (Pathak and Bhowmik 1998) and humans, predominantly children (Husband and McKellar 1970;Counter and Buchanan 2004). The higher incidence of acidosis in the pediatric age group than in adults exposed to elemental mercury in the literature can be explained by the difference in body weight and physiological maturity, which results in a much lower degree of exposure being necessary to bring mercury to highly toxic and potentially fatal concentrations in the blood and tissues.…”

Section: Discussioncontrasting

confidence: 67%

Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukine-1 Expression in Pulmonary Tissues of Rats

Raffee

Alawneh

Alassaf

et al. 2021

Preprint

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We investigated the effects of elemental mercury vapor inhalation on arterial blood gases (ABG's), lung histology, and interleukin-1 (IL-1) expression in pulmonary tissues in rats. A total of 42 Sprague-Dowley rats were divided randomly into three groups. Rats in the first group were used as control (CG). A Short-Term Group (STG) and Long-Term Group (LTG) were exposed to 7.3 µl of elemental mercury vapor for 21 days and 65 days, respectively. After exposure periods were completed, arterial blood samples were obtained, and ABG’s were measured. Lung tissue sections were prepared for histology evaluation and immune-stained to detect IL-1 expression. There was a significant decrease in body weight in both STG (15%) and LTG (22%) compared to the CG. In the LTG, six rats died (43%), while none of the rats in the STG died during the experiment. In both STG and LTG, a significant acid-base imbalance was characterized by a significant decrease in blood PH values and a significant increase in PCO2 values. Both PO2 and SpO2 blood values were significantly decreased in the STG and LTG, while no changes were observed in HCO3 values in all groups. Histological evaluation of lung tissues revealed severe lesions characterized by pulmonary emphysema and inflammatory cellular infiltrate. IL-1 expression in lung tissue was not significantly different between exposed rats and control subjects. These results indicate significant alterations in blood acid-base status characterized by severe respiratory acidosis with hypoxemia and no evidence of compensatory alkalosis in rats after short and long-term elementary mercury vapor exposure.

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“…As the degree of visceraabdominal disproportion is usually too great to permit immediate closure of the abdominal wall, a staged approach must be used. There are many methods of temporary closure and/or topical coverage described in the literature, with all methods having their supporters and detractors [21,22]. Although many children can be successfully closed using a silo in the neonatal period, those with prematurity, significant pulmonary hypoplasia and/or cardiac anomalies, and those with chromosomal abnormalities often do not tolerate reduction of a silo and require initial nonoperative management as a bridge to delayed closure [19,23].…”

Section: Discussionmentioning

confidence: 99%

Delayed management of giant omphalocele using silver sulfadiazine cream: an 18-year experience

Ein

Langer

2012

Journal of Pediatric Surgery

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Infantile Renal Tubular Acidosis Due to Mercury Poisoning

Cited by 13 publications

References 20 publications

Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukin-1 Expression in Pulmonary Tissues of Rats

Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukin-1 Expression in Pulmonary Tissues of Rats

Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukine-1 Expression in Pulmonary Tissues of Rats

Delayed management of giant omphalocele using silver sulfadiazine cream: an 18-year experience

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