Unusual case of mercury poisoning.

Johnson, H. R.; Koumides, O.

doi:10.1136/bmj.1.5536.340

Cited by 50 publications

(21 citation statements)

References 10 publications

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“…route, whereas those in the left ventricle and bilaterally in the renal pelvis suggested the systemic arterial embolization and renal excretion (32). Cardiac Hg deposits inducing inflammatory infiltrates with necrosis of myocardial fibers (16,17) and benign granulomatous fibrosis (48) may be responsible for the ST changes (10), as those we observed in our patient. In agreement with previous reports (52), we found mild hepato-toxic effects.…”

Section: Discussionsupporting

confidence: 52%

“…The overall Hg 0 intake assumed by our patient (about 500 g) is one of the largest reported in similar cases (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Fatal outcomes are rather uncommon after i.v.…”

Section: Discussionmentioning

confidence: 59%

“…Hg was determined also in plasma (HgP, days 1-3 and 8-19) and in the bronchoalveolar fluid drained from the endotracheal tube (HgBF) (days [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. On the 14th day, we performed a chelation challenge test with 300 mg of meso-2,3-dimercaptosuccinic acid (succimer, DMSA), in three equal doses every 8 h, and strictly monitored HgB, HgP, and HgU, after each dose.…”

Section: Methodsmentioning

confidence: 99%

“…Deliberate i.v. injection occurred in suicidal (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) as well as homicidal attempts 29), in drug and alcohol addicts (30)(31)(32)(33)(34)(35)(36), and in athletes wishing to improve their performances (37)(38)(39). Injected Hg 0 causes few signs of mercurialism and infrequent renal involvement (40).…”

Section: Introductionmentioning

confidence: 99%

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Toxicokinetics and toxicodynamics of elemental mercury following self-administration

Palma

Mariotti

Lonati

et al. 2008

Clinical Toxicology

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Introduction. Intravenous injection of mercury has seldom been reported, especially in cases of attempted suicide, and is associated with variable clinical outcomes. Case report. A young woman came to our attention after self-injecting and ingesting mercury drawn from 37 thermometers. The patient suffered lung embolization complicated by adult respiratory distress syndrome (ARDS), toxic dermatitis, anemia, mild hepato-renal impairment, and died after 30 days. Mercury was monitored in biological fluids (blood, plasma, urine, and bronchoalveolar fluid) to study its toxicokinetics and to evaluate dose-effect relationships. Its urinary clearance significantly increased after a chelation challenge test with meso-2,3-dimercaptosuccinic acid (DMSA) (median values of 2.48 and 8.85 before and after the test, respectively, p < 0.05). Conclusions. Mercury poisoning by intravenous injection is a clinical emergency, potentially leading to death. When injected, the element has a very slow clearance, mainly renal. Our data do not allow any conclusion about the effectiveness of chelation therapy.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Toxicokinetics and toxicodynamics of elemental mercury following self-administration

Palma

Mariotti

Lonati

et al. 2008

Clinical Toxicology

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“…Injury and toxicity as a result of accidental or intentional injection of metallic mercury are uncommon. The effects are caused by the wide distribution throughout all organ systems of the oxidized forms of mercury, and have ranged from a local inflammatory reaction (2,4) to systemic effects on the kidneys, lung and central nervous system (5,6). The history may be unclear in some cases and symptoms may range from local edema to nausea, vomiting, gastrointestinal bleeding, renal failure and neurologic complaints.…”

Section: Discussionmentioning

confidence: 99%

Migration of metallic mercury in the hand

1996

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NJ Wells, JC Boyle, V Wood. Migration of metallic mercury in the hand. Can J Plast Surg 1996;4(2):114-116. A case of an unusual injury to the hand involving a broken thermometer, resulting in migration of mercury within the tissues requiring surgical removal, is described.Migration de mercure métal dans la main RÉSUMÉ : Un cas de blessure inhabituelle à la main impliquant un thermomètre brisé, et qui a entraîné une migration du mercure à l'intérieur des tissus exigeant une extraction chirurgicale, est décrit.Subcutaneous injection of metallic mercury is uncommon and most articles have emphasized the potential systemic complications (1,2). Only a few articles have dealt with the local injury describing it as a foreign body granuloma-type reaction (3,4). This paper reports a case of palmer injection of mercury from a broken thermometer and the unusual local response. CASE REPORTA 34-year-old right hand dominant female suffered a puncture wound to the left hand over the base of the thenar eminence. At the time of initial assessment her hand examination was normal except for a small puncture wound at the base of the thenar eminence. At that time, the wound was opened over 1 cm and the visible superficial mercury was removed. There was felt to be residual mercury at a deeper level so a radiograph was obtained which confirmed this (Figure 1).The patient was referred to a hand surgeon and examined 12 days after the initial injury. The clinical examination was essentially unchanged; however, a repeat radiograph was obtained. This demonstrated the presence of the mercury but it appeared to have spread more proximally and distally compared with the initial radiograph (Figure 2).The patient underwent surgical removal of the mercury with the aid of fluoroscopy and loupe magnification. Intraoperatively it was noted that the mercury started in close proximity to the superficial palmar arch and extended along the fascia of the first lumbrical. The fascia and mercury were excised en bloc to remove all of the mercury droplets. A follow-up radiograph showed no remaining mercury and the patient has healed without incident.

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Fatality Following Metallic Mercury Aspiration During Removal of a Long Intestinal Tube

Zimmerman¹

1969

JAMA

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Unusual case of mercury poisoning.

Cited by 50 publications

References 10 publications

Toxicokinetics and toxicodynamics of elemental mercury following self-administration

Toxicokinetics and toxicodynamics of elemental mercury following self-administration

Migration of metallic mercury in the hand

Fatality Following Metallic Mercury Aspiration During Removal of a Long Intestinal Tube

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