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

Zhang, Lin; Liu, Fuyou; Peng, Youming; Sun, Lin; Chen, Chunguo

doi:10.5144/0256-4947.2014.257

Cited by 24 publications

(23 citation statements)

References 14 publications

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“…Mercury is absorbed by the skin and can cause many complications such as nephrotic syndrome and peripheral nerve injury. Unfortunately, skinlightening creams containing inorganic mercury are widely used by dark-skinned people to achieve a lighter skin tone [10,18]. In China, TCM can be confused with CFRs.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, EMG showed that most nerve damage in patients was caused by CFRs, likely because occupational disease patients tend to be admitted to occupational disease hospitals. Mercury has a strong a nity for renal tissue which can lead to NS [18,[25][26][27]. Mercury-induced MN results from long-term use of mercury-containing skin-lightening cosmetics or from occupational contact with mercury [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Sun

Long

Zhao

et al. 2020

Preprint

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Background: There are no reports on the incidence of mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with mercury poisoning. Methods: Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. Results: First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3%), kidney (16.4%) and breathing (8.0%). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.5 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months.Conclusions: Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Sun

Long

Zhao

et al. 2020

Preprint

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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%

“…The specific regimen of mercury detoxification was an intramuscular injection (0.125~0.250 g/d) of sodium dimercaptosulfonate (DMPS) for 3 consecutive days followed by a 4-day interval [ 13 , 14 ]. The regimen continued until the urine mercury level dropped to the normal range or severe side-effects occurred.…”

Section: Methodsmentioning

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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“…Significant level of As and Hg was reported with Mohammad et al, 2017 in skin bleaching agents of Caribbean region [50] As used in skin cream and make-up powder causes skin problems, lung cancer, circulatory and peripheral neuropathy, and increased risk of gastrointestinal and urinary tract malignancies [51,52]. Several recent and older studies reported nephrotic syndrome from repeated exposure of mercury and other heavy metals from skin lightening agent [53][54][55][56][57][58]. Dental amalgam has been used as a restorative treatment in dentistry for well over 170 years.…”

Section: Introductionmentioning

confidence: 97%

Heavy Metals: The Notorious Daredevils of Daily Personal Care Products- Mini Review

Mohiuddin¹

2019

SARJPS

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Personal care products and facial cosmetics are commonly used by millions of consumers on a daily basis. Direct application of cosmetics on human skin makes it vulnerable to a wide variety of ingredients. Despite the protecting role of skin against exogenous contaminants, some of the ingredients in cosmetic products are able to penetrate the skin and to produce systemic exposure. Consumers' knowledge of the potential risks of the frequent application of cosmetic products should be improved. While regulations exist in most of the high-income countries, in low income countries there is a lack of similar standards. In most countries for which these legal regulations have been identified, restrictions on the permissible level of heavy metals are strict. There is a need for enforcement of existing rules, and rigorous assessment of the effectiveness of these regulations. The occurrence of metals in cosmetic products is of concern for three principal reasons: (i) the use of cosmetic products could represent a possible source of population-wide exposure daily, and often long-term exposure to metals in cosmetic products (ii) metals can accumulate in the body over time, and (iii) a number of them are known to exhibit different chronic health effects, such as cancer, contact dermatitis, developmental, neurological and reproductive disorders, brittle hair and hair loss. Some metals are potent endocrine disruptors and respiratory toxins. Moreover, some metals, such as Cd, As, Pb, Hg and Sb, are exceptionally toxic with a wide variety of chronic health effects, whereas Cr, Ni and Co are well known skin sensitizers. Since the issue of heavy metals as deliberate cosmetic ingredients has been addressed, attention is turned to the presence of these substances as impurities.

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

Cited by 24 publications

References 14 publications

Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

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

Heavy Metals: The Notorious Daredevils of Daily Personal Care Products- Mini Review

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