Lesson of the week: Mercury poisoning after spillage at home from a sphygmomanometer on loan from hospital

Mercury intoxication resulting from school barometers in three unrelated adolescents

“…The latter was seen in our case 3. Neurological recovery may be slow [16]; luckily, the symptoms of our patient resolved rapidly after appropriate therapy. On the other hand, case 1 had a convulsion and CNS involvement was documented by EEG.…”

“…In cases of severe hypertension and elevated catecholamines, blood and urine mercury levels should be determined to eliminate the diagnosis of mercury intoxication even if there is no definite history of exposure [2]. Recent reports state that hypertension resulting from mercury poisoning is refractory requiring two or three anti-hypertensive agents [16,20]; this was also true for our patients.…”

“…Metallic mercury is found not only in barometers, but also in thermometers and sphygnomanometers. Rennie et al [16] described a 9-year-old boy who developed severe neurological symptoms after breakage of a sphygnomanometer, used for the home blood pressure monitoring of his sister. Baudain et al [3] reported a 28-month-old boy, who was admitted because of suspected pheochromocytoma 3 months after spillage of mercury from a broken thermometer in the kitchen.…”

“…For a paediatrician, the most important use of mercury is in thermometers, sphygnomanometers and barometers, which are mainly used in the home, in hospitals and in schools where children spend most of their time. If these devices are broken accidentally, spillage of mercury droplets may cause chronic elemental mercury intoxication [3,16]. This syndrome includes neuropsychiatric disturbances, peripheral neuropathy, renal involvement presenting as proteinuria or tubulopathy, and skin rash [7].…”

Mercury Sphygmomanometers Should Not be Abandoned: An Advisory Statement From the Council for High Blood Pressure Research, American Heart Association

“…5 One detailed report has provided data suggesting that volatilized mercury, after spillage of mercury, produced reversible neurological symptoms. 6 Nevertheless, modern mercury sphygmomanometers are available in models that prevent accidental spillage of mercury, which essentially eliminates the concern for this rare occurrence.…”