The clinical analysis of mercury poisoning in 92 cases

peripheral_neuropathyZhonghua Nei Ke Za Zhi. 2011 Aug;50(8):687-9.

The clinical analysis of mercury poisoning in 92 cases

Liu XL, Wang HB, Sun CW, Xiong XS, Chen Z, Li ZS, Han B, Yang G.

Source: Department of Nephrology, Affiliated Hospital of the Academy of Military Medical Sciences, Poison Control Center of PLA, Beijing 100071, China.

Abstract

OBJECTIVE:

To summarize the clinical features of mercury poisoning diagnosed by blood and urine tests for improving the diagnosis and treatment of the disease.

METHODS:

Poisoning causes, clinical manifestations, diagnosis, treatment and prognosis were retrospectively reviewed in 92 in-patients with mercury poisoning in our hospital from January 2000 to April 2010.

RESULTS:

Of the 92 patients, 37 were male and 55 were female with an average age of 33.1 (2 – 65) years old. The mercury poisoning was caused by occupational exposure and non-occupational exposure, such as iatrogenic exposure, life exposure and wrong intake or suicidal intake of mercury-containing substances, mainly through respiratory tract, digestive tract and skin absorption.

The most common clinical symptoms were as the followings:

  • nervous system symptom, such as memory loss in 50 cases (54.3%),
  • fatigue in 34 (37.0%),
  • numb limb in 25 (27.2%),
  • dizziness and headache in 22 (23.9%),
  • cacesthesia in 20 (21.7%),
  • fine tremor (finger tip, tongue tip, eyelids) in 15 (16.3%),
  • insomnia and more dreams in 12 (13.0%);
  • gastrointestinal symptoms: nausea in 16 (17.4%),
  • abdominal pain in 14 (15.2%),
  • stomatitis in 5 (5.4%);
  • joint and muscle symptoms: muscle pain in 16 (17.4%),
  • joint pain in 5 (5.4%);
  • cardiovascular system: chest tightness, heart palpitations in 6 (6.5%);
  • urinary system: edema in 9 (9.8%);
  • other system: hidrosis in 20 (21.7%).

After the treatment with sodium dimercaptopropane sulfonate (DMPS), the symptoms were gradually alleviated. Their gastrointestinal, cardiovascular symptoms were alleviated within 2 weeks; neurological symptoms were alleviated within 3 months; kidney damage showed a slower recovery and could be completely alleviated within 6 months.

CONCLUSIONS:

Because of its diverse clinical symptoms, the mercury poisoning was easy to misdiagnosis and missed diagnosis; therefore the awareness of the disease should be further enhanced. Leaving from the poisoning environment timely and giving appropriate treatment with DMPS will lead to a satisfactory prognosis.

PMID: 22093564

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