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Mercury intoxication in a 2-year-old girl: a diagnostic challenge for the physician

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Abstract

A 2-year-old girl presented with hypertension, anorexia and vomiting, restlessness, insomnia and acrodynia. Her blood pressure upon arrival was 145/98 mmHg. Ultrasound of the abdomen, CT scan of chest, abdomen and pelvis, and echocardiogram, were normal. Urinary levels of catecholamines were elevated, urine level of mercury was found to be high (33.2 μg/g creatinine), although blood level was normal (>0.5 μg/dl, reference value 0–4 μg/dl). Following a 1-month course of oral treatment with dimercaptosuccinic acid (DMSA) the child’s symptoms and signs resolved, and urinary mercury and catecholamines levels normalized. Mercury intoxication should be suspected in a patient with severe hypertension, personality changes and acrodynia. Normal blood levels of mercury do not exclude this diagnosis, and catecholamine levels may serve as a surrogate marker for confirmation of the diagnosis and to evaluate response to treatment.

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Authors and Affiliations

  1. Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Yael Michaeli-Yossef, Matitiahu Berkovitch & Michael Goldman

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Matitiahu Berkovitch & Michael Goldman

Authors
  1. Yael Michaeli-Yossef
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  2. Matitiahu Berkovitch
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  3. Michael Goldman
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Correspondence to Michael Goldman.

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Michaeli-Yossef, Y., Berkovitch, M. & Goldman, M. Mercury intoxication in a 2-year-old girl: a diagnostic challenge for the physician. Pediatr Nephrol 22, 903–906 (2007). https://doi.org/10.1007/s00467-007-0430-5

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  • DOI: https://doi.org/10.1007/s00467-007-0430-5

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