Toxicokinetics and toxicodynamics of elemental mercury following self-administration.

Abstract

INTRODUCTION:

Intravenous injection of mercury has seldom been reported, especially in cases of attempted suicide, and is associated with variable clinical outcomes.

CASE REPORT:

A young woman came to our attention after self-injecting and ingesting mercury drawn from 37 thermometers. The patient suffered lung embolization complicated by adult respiratory distress syndrome (ARDS), toxic dermatitis, anemia, mild hepato-renal impairment, and died after 30 days. Mercury was monitored in biological fluids (blood, plasma, urine, and bronchoalveolar fluid) to study its toxicokinetics and to evaluate dose-effect relationships. Its urinary clearance significantly increased after a chelation challenge test with meso-2,3-dimercaptosuccinic acid (DMSA) (median values of 2.48 and 8.85 before and after the test, respectively, p < 0.05).

CONCLUSIONS:

Mercury poisoning by intravenous injection is a clinical emergency, potentially leading to death. When injected, the element has a very slow clearance, mainly renal. Our data do not allow any conclusion about the effectiveness of chelation therapy.

• Authors: Giuseppe De Palma, Orietta Mariotti, Davide Lonati, Matteo Goldoni, Simona Catalani, Antonio Mutti, Carlo Locatelli, Pietro Apostoli
• Journal: Clinical toxicology (Philadelphia, Pa.) (Clin Toxicol (Phila)) Vol. 46 Issue 9 Pg. 869-76 (Nov 2008) ISSN: 1556-9519 [Electronic] England
• PMID: 18787993 (Publication Type: Case Reports, Journal Article)

Chemical References

• Chelating Agents
• Succimer
• Mercury

Topics

• Adult
• Chelating Agents (therapeutic use)
• Dose-Response Relationship, Drug
• Female
• Humans
• Injections, Intravenous
• Mercury (administration & dosage, pharmacokinetics, toxicity)
• Mercury Poisoning (physiopathology)
• Pulmonary Embolism (chemically induced)
• Respiratory Distress Syndrome (chemically induced)
• Succimer (therapeutic use)
• Suicide
• Thermometers