TY - JOUR
T1 - Mercury intoxication in a 2-year-old girl
T2 - A diagnostic challenge for the physician
AU - Michaeli-Yossef, Yael
AU - Berkovitch, Matitiahu
AU - Goldman, Michael
PY - 2007/6
Y1 - 2007/6
N2 - 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.
AB - 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.
KW - Acrodynia
KW - Catecholamines
KW - DMSA
KW - Hypertension
KW - Mercury intoxication
UR - http://www.scopus.com/inward/record.url?scp=34247328086&partnerID=8YFLogxK
U2 - 10.1007/s00467-007-0430-5
DO - 10.1007/s00467-007-0430-5
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C2 - 17310361
AN - SCOPUS:34247328086
VL - 22
SP - 903
EP - 906
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 6
ER -