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

Yael Michaeli-Yossef, Matitiahu Berkovitch, Michael Goldman

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)903-906
Number of pages4
JournalPediatric Nephrology
Volume22
Issue number6
DOIs
StatePublished - Jun 2007

Keywords

  • Acrodynia
  • Catecholamines
  • DMSA
  • Hypertension
  • Mercury intoxication

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