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European Journal of Pediatrics

, Volume 162, Issue 7–8, pp 559–561 | Cite as

An 11-month-old boy with psychomotor regression and auto-aggressive behaviour

  • Christina Chrysochoou
  • Christoph Rutishauser
  • Christine Rauber-Lüthy
  • Thomas Neuhaus
  • Eugen Boltshauser
  • Andrea Superti-Furga
Your Diagnosis

Clinical information

An 11-month-old Swiss boy was brought to his paediatrician. He had been in good health and had developed normally until then, but his parents mentioned that over the previous 2 weeks, the child no longer laughed or played, was becoming more and more restless, and slept only 1 to 2 h a night. He was no longer able to crawl and to stand up, and he had lost weight. Clinical examination revealed swollen hands and feet with skin desquamation, axial hypotonia and brisk reflexes. The child sweated profusely, refused to crawl or stand, showed stereotypic movements of the hands (kneading) and repeatedly bit objects or his own hands.

Upon admission to the regional hospital, blood cell count, electrolytes, blood gas analysis, thyroid hormones and cerebrospinal fluid were normal. Liver and kidney parameters were normal, but plasma LDH and CK were increased to 724 U/l (normal <296 U/l) and to 270 U/l (normal <234 U/l), respectively. EEG, chest X-ray film, abdominal sonography,...

Keywords

Uric Acid Arterial Hypertension Fabry Disease Coeliac Disease Mercury Intoxication 

Notes

Acknowledgements

We are grateful to our colleagues Dr. Bianca Maria Regazzoni and Dr. Vincenzo D'Apuzzo (Mendrisio) as well as to Dr. Gian Paolo Ramelli (Bellinzona) for sharing clinical data and videotapes which were useful in reviewing the case.

References

  1. 1.
    Baudouin V, Bocquet N, Rybojad M, Lissak N, Broux F, Grall M, Loirat C (1997) Clinical quiz. Mercury poisoning in children. Pediatr Nephrol 11: 263–264PubMedGoogle Scholar
  2. 2.
    Black J (1999) The puzzle of pink disease. J Royal Soc Med 92: 478–481CrossRefGoogle Scholar
  3. 3.
    Boyd AS, Seger D, Vannucci S, Langley M, Abraham JL, King LE Jr (2000) Mercury exposure and cutaneous disease. J Am Acad Dermatol 43: 81–90CrossRefPubMedGoogle Scholar
  4. 4.
    Cloarec S, Deschenes G, Sagnier M, Rolland JC, Nivet H (1995) Hypertension artérielle par intoxication au mercure: intérêt diagnostique du captopril (Arterial hypertension due to mercury poisoning: diagnostic value of captopril). Arch Pediatr 2: 43–46CrossRefPubMedGoogle Scholar
  5. 5.
    Fanconi G, Bozsztejn A (1948) Die Feersche Krankheit (Akrodynie) und Quecksilbermedikation. Helv Paediatr Acta 3: 264–271PubMedGoogle Scholar
  6. 6.
    Henningsson C, Hoffmann S, McGonigle L, Winter JS (1993) Acute mercury poisoning (acrodynia) mimicking pheochromocytoma in an adolescent. J Pediatr 122: 252–253CrossRefPubMedGoogle Scholar
  7. 7.
    Pierson M, Vert P, Marchal C, Brochier A (1965) Convulsions, paroxysmes hypertensifs et elimination elevée de catecholamines au cours de acrodynie infantile. Arch Fr Pediatr 22: 233–238PubMedGoogle Scholar
  8. 8.
    Shih H, Gartner JC Jr (2001) Weight loss, hypertension, weakness, and limb pain in an 11-year-old boy. J Pediatr 138: 566–569CrossRefPubMedGoogle Scholar
  9. 9.
    Velzeboer SC, Frenkel J, de Wolff FA (1997) A hypertensive toddler. Lancet 349: 1810CrossRefPubMedGoogle Scholar
  10. 10.
    Von Muhlendahl KE (1990) Intoxication from mercury spilled on carpets. Lancet 336: 1578Google Scholar
  11. 11.
    Warkany J (1966) Acrodynia - postmortem of a disease. Am J Dis Child 112: 147–156PubMedGoogle Scholar
  12. 12.
    Warkany J, Hubbard DM (1948) Mercury in the urine of children with acrodynia. Lancet 1: 829–830CrossRefPubMedGoogle Scholar
  13. 13.
    Wossmann W, Kohl M, Gruning G, Bucsky P (1999) Mercury intoxication presenting with hypertension and tachycardia. Arch Dis Child 80: 556–557CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Christina Chrysochoou
    • 1
  • Christoph Rutishauser
    • 1
  • Christine Rauber-Lüthy
    • 2
  • Thomas Neuhaus
    • 1
  • Eugen Boltshauser
    • 1
  • Andrea Superti-Furga
    • 1
    • 3
  1. 1.Department of PaediatricsUniversity Children's HospitalZürichSwitzerland
  2. 2.Swiss Toxicological Information CentreZürichSwitzerland
  3. 3.Division of Molecular PaediatricsCHUVLausanneSwitzerland

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