MERCURY TOXICITY

Clinical

Skin findings include gingivitis, erythema of the palms and soles, acral desquamation, and a miliaria-like rash [J Res Med Sci. 2015 Mar; 20(3): 308–311].

Systemic symptoms include hypertension, tachycardia, chronic sweating, fever, fatigue, abdominal pain, photophobia, and neuropsychiatric symptoms.

Diagnosis

Diagnosis is made by history, symptomatology and confirmed by mercury level measurement, usually serum mercury, but also of the hair (and sometimes urine).

Treatment

Dimercaptosuccinic acid (DMSA) is the only chelator that was approved by the US Food and Drug Administration for treating mercury poisoning in children. If unavailable, D-penicillamine has been employed. Obviously, avoidance of mercury is key. Fabapentin and tramadol are effective in the treatment of neuropathic pain, mood disorders, and sleep disturbances of mercury poisoning.

References

CMAJ. 2003 Jan 21; 168(2): 201

Dermatology Online Journal 22(3)


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