Abstract
Three adolescents with severe hypertension due to mercury intoxication are presented. Two of them had skin rash, signs and symptoms of central nervous system involvement, peripheral neuropathy and mild-to-moderate proteinuria in addition to hypertension. All three patients had a history of exposure to mercury, the source being broken barometers taken from school laboratories 2–4 months previously. Urine and blood mercury levels were consistent with mercury intoxication. The patients were treated with chelation therapy. One of them died; the others recovered over a period of 1–4 months. Conclusion:mercury intoxication should be considered in any child with signs and symptoms of hypertension, skin rash, peripheral neuropathy and behavioural changes. The parents and school administrators, as well as paediatricians, should be aware of the potential risks of mercury and should be encouraged to avoid mercury-containing devices in schools and households.
Similar content being viewed by others
Abbreviations
- BAL :
-
British anti-Lewisite
- DMPS :
-
2,3-dimercaptopropane-1-sulphonate
- VMA :
-
vanillylmandelic acid
References
Aposhian HV (1998) Mobilization of mercury and arsenic in humans by sodium 2,3-dimercapto-1-propane sulfonate (DMPS). Environ Health Perspect 106[Suppl 4]: 1017–1025
American Academy of Pediatrics (2001) Technical report: mercury in the environment: Implications for pediatricians. Pediatrics 108: 197–205
Baudouin V, Bocquet N, Rybojad M, Lissak N, Broux F, Grall M, Loirat C (1997) Clinical quiz. Pediatr Nephrol 11: 263–264
Beevers G, Lip GYH, O’Brien E (2001) ABC of hypertension: blood pressure measurement. BMJ 322: 1043–1047
Blair E, Cross RE, Stave GM, Hill WW, Smith J, Freeman JI, Newton DL, Pate WJ, Williams WA, MacCormack JN (1989) Elemental mercury vapor poisoning. MMWR 38: 770–772
Bolla KI, Cadet JL (1999) Exogenous acquired metabolic disorders of the nervous system: toxins and illicit drugs. In: Goetz CG, Pappert EJ (eds) Textbook of clinical neurology, 1st edn. WB Saunders, Philadelphia, pp 778–779
Chiang WK (2001) Mercury. In: Ford MD, Delaney KA, Ling LJ, Erickson T (eds) Clinical toxicology. WB Saunders, Philadelphia, pp 737–743
Chrysochoou C, Rutishauser C, Rauber-Lüthy C, Neuhaus T, Boltshauser E, Superti-Furga A (2003) An 11-month-old boy with psychomotor regression and auto-aggressive behaviour. Eur J Pediatr 162: 559–561
Ellenhorn MJ, Schonwald S, Ordog G, Wasserberger J (1997) Ellenhorn’s medical toxicology: diagnosis and treatment of human poisoning, 2nd edn. Williams and Wilkins, Philadelphia
Forman J, Moline J, Cernichiari E, Sayegh S, Torres C, Landrigan MM, Hudson J, Adel HN, Landrigan PJ (2000) A cluster of pediatric metallic mercury cases treated with meso-2,3-dimercaptosuccinic acid (DMSA). Environ Health Perspect 108: 575–577
Goto CS (2000) Heavy metal intoxication. In: Behrman RE, Kliegman RM, Jenson HB (eds) Nelson textbook of pediatrics, 16th edn. WB Saunders, Philadelphia, pp 2155–2156
Henningsson C, Hoffmann S, McGonigle L, Winter JSD (1993) Acute mercury poisoning (acrodynia) mimicking pheochromocytoma in an adolescent. J Pediatr 122: 252–253
Karagol U, Deda G, Kukner S, Ince E, Onal MZ (1998) Pain relief by carbamazepine in mercury poisoning. Eur J Pediatr 157: 260–261
Langford NJ, Ferner RE (1999) Toxicity of mercury. J Hum Hypertens 13: 651–656
O’Brien E (2000) Replacing the mercury sphygnomanometer. BMJ 320: 815–816
Rennie AC, McGregor-Schuerman M, Dale IM, Robinson C, McWilliam R (1999) Mercury poisoning after spillage at home from a sphygnomanometer on loan from hospital. BMJ 319: 366–367
Salonen J, Seppanen K, Nyyssönen K, Korpela H, Kauhanen J, Kantola M, Tuomilehto J, Esterbauer H, Tatzber F, Salonen R (1995) Intake of mercury from fish, lipid peroxidation, and the risk of myocardial infarction and coronary, cardiovascular, and any death in eastern Finnish men. Circulation 91: 645–655
Shih H, Gartner JC. (2001) Weight loss, hypertension, weakness and limb pain in an 11-year-old boy. J Pediatr 138: 566–569
Sibbuld B (2003) City bans medical devices that contain mercury. JAMC 168: 78
Torres AD, Rai AN, Hardiek ML (2000) Mercury intoxication and arterial hypertension: report of two patients and review of the literature. Pediatrics 105: e34
Wössmann W, Kohl M, Grüning G, Bucsky P (1999) Mercury intoxication presenting with hypertension and tachycardia. Arch Dis Child 80: 556–557
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Koyun, M., Akman, S. & Güven, A.G. Mercury intoxication resulting from school barometers in three unrelated adolescents. Eur J Pediatr 163, 131–134 (2004). https://doi.org/10.1007/s00431-003-1389-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-003-1389-2