Case Report
Acute Mercury Poisoning by Intentional Ingestion of Mercuric Chloride
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MINORU YOSHIDA, HIROSHI SATOH1, MICHIROU IGARASHI2, KATSUYA AKASHI3, YUKIO YAMAMURA4 and KATSUMI YOSHIDA4
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Department of Chemistry, St. Marianna University School of Medicine, 1Department of Environmental Health Sciences, Tohoku University Graduate School of Medicine, Sendai 980-77, 2The Second Department of Surgery, 3Department of Acute Medicine, and 4Department of Preventive Medicine, St. Marianna University School of Medicine, Kawasaki 216
A 26-year-old woman ingested 0.9 g of mercuric chloride in a suicide attempt and developed hematemesis, melena and acute renal failure. Anuria persisted for 14 days. She was treated by plasma exchange, hemodialysis and peritoneal dialysis in combination with continued dimercaprol chelation. While hemodialysis was ineffective in removing the mercury, plasma exchange effectively eliminated mercury. After two plasma exchange therapies, mercury concentration in the blood decreased linearly on a log scale with half-lives of 23.1 days for whole blood and 19.1 days for plasma, using first-order kinetics. One month after ingestion, renal function recovered to normal as judged by serum creatine and blood urea nitrogen levels, although the b2-microglobulin level in urine was still elevated. At a follow-up examination four months later, renal function was found to be completely normal. This indicates that the renal damage caused by acute mercuric chloride poisoning may not be permanent.
Key words---
mercuric chloride; inorganic mercury poisoning; renal failure; plasma exchange; hemodialysis
© 1997 Tohoku University Medical Press
Tohoku J. Exp. Med., 1997, 182, 347-352
Address for reprints:
Dr. Minoru Yoshida, Department of Chemistry, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216, Japan.
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