Minimal-change nephrotic syndrome due to occupational mercury vapor inhalation

Campbell, G.; Leitch, D. R.; Lewington, Andrew; Dargan, Paul I.; Baker, Richard J.

doi:10.5414/cnp72216

Cited by 12 publications

(5 citation statements)

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“… 15 , 16 In addition, suction mercury vapor can be another cause of minimal change disease other than skin-lightening creams. 17 Renal function is usually normal in patients with nephrotic syndrome caused by skin-lightening cream if there are no other concomitant diseases.…”

Section: Discussionmentioning

confidence: 99%

Nephrotic syndrome of minimal change disease following exposure to mercury-containing skin-lightening cream

Zhang

Liu

Peng

et al. 2014

Annals of Saudi Medicine

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A 28-year-old female suffered from nephrotic syndrome after a long-term use of mercury-containing, skin-lightening cream. The blood and urinary mercury content of this patient increased with use. Renal biopsy showed minimal change disease. Her symptoms were relieved 6 months after discontinuing use of the cream and receiving sodium dimercaptosulfonate and glucocorticosteroid treatments. Proteinuria disappeared, and blood and urinary mercury levels returned to normal. Previous reports of nephrotic syndrome caused by mercury-containing, skin-lightening creams have mostly been identified as being due to membranous nephropathy. Minimal change disease has been reported in a few case reports published in the English language. Here we report a case of nephrotic syndrome with minimal change disease following exposure to a mercury-containing, skin-lightening cream. We also reviewed relevant published reports to summarize clinical features and treatments and to explore the possible mechanisms involved.

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Section: Discussionmentioning

confidence: 99%

Nephrotic syndrome of minimal change disease following exposure to mercury-containing skin-lightening cream

Zhang

Liu

Peng

et al. 2014

Annals of Saudi Medicine

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“…A 25-year-old man presented with nephrotic syndrome after occupational exposure to mercury vapor. The kidney biopsy revealed MCD, and the patient was administered chelation therapy with DMPS along with steroids, leading to the complete resolution of his nephrotic syndrome [39]. Finally, another report mentioned inhalation and vapor mercury poisoning in a family of four members.…”

Section: Discussionmentioning

confidence: 99%

Nephrotic Syndrome Associated With Heavy Metals Exposure: A Case Report and Literature Review

Kalogeropoulos,

Sardeli,

Liapis

et al. 2024

Cureus

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Heavy metals are found in many products used in everyday life. In addition, many workers are exposed to higher concentrations of such metals in their work environment. Many of these metals may cause toxic effects in humans and there are many reports relating them to the occurrence of kidney disorders such as nephrotic syndrome. In this study, we present a case of a 38-year-old woman with nephrotic syndrome suspected to be related to heavy metal toxicity, after ruling out all other secondary causes. At the same time, she proved refractory to multiple therapies. Furthermore, a related literature review regarding the occurrence of nephrotic syndrome in patients with heavy metal exposure is presented with emphasis on the importance of considering them as a secondary cause, especially in cases that appear resistant to treatment.

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“… Total patients with biopsies 97 MN 69 (71.1%) Membranous nephropathy after use of UK-manufactured skin creams containing mercury Chakera et al (2011) [ 18 ] 2 Mercury-induced membranous nephropathy: clinical and pathological features Li et al (2010) [ 6 ] 11 Membranous nephropathy from exposure to mercury in the fluorescent-tube recycling industry Aymaz et al (2001) [ 21 ] 2 Nephrotic syndrome after contact with mercury. A report of five cases, three after the use of ammoniated mercury ointment Becker et al (1962) [ 22 ] 5 MCD 26 (26.8%) Nephrotic syndrome of minimal change diseasefollowing exposure to mercury-containingskin-lightening cream Zhang et al (2014) [ 14 ] 1 Mercury-induced nephrotic syndrome: a case report and review of the literature Wagrowska-Danilewicz et al (2014) [ 23 ] 1 Minimal change disease caused by exposure to mercury-containing skin lightening cream: a report of 4 cases Tang et al (2013) [ 17 ] 4 Minimal-change nephrotic syndrome due to occupational mercury vapor inhalation Campbell et al (2009) [ 24 ] 1 FSGS 2 (2.1%) Mercury-Associated Nephrotic Syndrome: A Case Report and Systematic Review of the Literature Miller et al (2013) [ 25 ] 1 Abbreviations: MN m embranous nephropathy, MCD minimal change disease, FSGS focal segmental glomerular sclerosis …”

Section: Discussionmentioning

confidence: 99%

Mercury-associated glomerulonephritis: a retrospective study of 35 cases in a single Chinese center

Qin

Zhang

et al. 2019

BMC Nephrol

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Background Long-term exposure of mercury may induce glomerulonephritis. Clinical and pathological features of mercury-associated glomerulonephritis are not fully clear. This study retrospectively analyzed 35 cases of mercury-associated glomerulonephritis in a single Chinese center. Methods Thirty-five patients of mercury-associated glomerulonephritis were enrolled. Clinical data on diagnosis and during follow-up were collected. Plasma anti-phospholipase A2 receptor (PLA2R) antibody, glomerular PLA2R and glomerular IgG subclasses deposition were detected in the cases with membranous nephropathy (MN). Results Mercury exposure was caused by skin lighting cream (20 patients), mercury-containing pills (9 patients), hair-dyeing agents (4 patients), and unidentified reasons (2 patients). All patients presented with proteinuria and normal renal function. The median of urinary protein was 4.6 (range 1.6~19.7) g/24 h. Twenty-two patients (62.9%) had nephrotic syndrome. Renal histopathology showed minimal change disease (MCD) in 21 patients (60.0%), MN in 13 (37.1%) and focal segmental glomerular sclerosis (FSGS) in 1 patient (2.9%). The proportion of MCD increased along with urinary mercury concentration ( P = 0.024). In 13 cases of MN, all patients were negative for plasma anti-PLA2R antibody and glomerular PLA2R antigen. IgG1 (61.5%) and IgG4 (46.2%) deposits were noted along the glomerular capillary loops. Among the 16 patients received mercury detoxification monotherapy, 14 patients received 4.5 ± 2.8 (range 1~12) rounds of regimen and achieved complete remission in 4.5 (range 0.3~23.0) months, 2 patients stayed no remission. Conclusions MCD was the most common pathological type of mercury-associated glomerulonephritis, followed by MN. The proportion of MCD increased along with the increase of urinary mercury concentration. Most patients could achieve complete remission after mercury detoxification.

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Minimal-change nephrotic syndrome due to occupational mercury vapor inhalation

Cited by 12 publications

References 0 publications

Nephrotic syndrome of minimal change disease following exposure to mercury-containing skin-lightening cream

Nephrotic syndrome of minimal change disease following exposure to mercury-containing skin-lightening cream

Nephrotic Syndrome Associated With Heavy Metals Exposure: A Case Report and Literature Review

Mercury-associated glomerulonephritis: a retrospective study of 35 cases in a single Chinese center

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