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Toxicokinetics and toxicodynamics of elemental mercury following self-administration. 2008

Giuseppe De Palma, and Orietta Mariotti, and Davide Lonati, and Matteo Goldoni, and Simona Catalani, and Antonio Mutti, and Carlo Locatelli, and Pietro Apostoli
Department of Experimental and Applied Medicine, Section of Industrial Hygiene, University of Brescia, Brescia, Italy. depalma@med.unibs.it

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

UI MeSH Term Description Entries
D007275 Injections, Intravenous Injections made into a vein for therapeutic or experimental purposes. Intravenous Injections,Injection, Intravenous,Intravenous Injection
D008628 Mercury A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to MERCURY POISONING. Because of its toxicity, the clinical use of mercury and mercurials is diminishing.
D008630 Mercury Poisoning Poisoning that results from chronic or acute ingestion, injection, inhalation, or skin absorption of MERCURY or MERCURY COMPOUNDS. Poisoning, Mercury,Mercury Poisonings,Poisonings, Mercury
D011655 Pulmonary Embolism Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS. Pulmonary Thromboembolism,Thromboembolism, Pulmonary,Embolism, Pulmonary,Embolisms, Pulmonary,Pulmonary Embolisms,Pulmonary Thromboembolisms,Thromboembolisms, Pulmonary
D012128 Respiratory Distress Syndrome A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA. ARDS, Human,Acute Respiratory Distress Syndrome,Adult Respiratory Distress Syndrome,Pediatric Respiratory Distress Syndrome,Respiratory Distress Syndrome, Acute,Respiratory Distress Syndrome, Adult,Respiratory Distress Syndrome, Pediatric,Shock Lung,Distress Syndrome, Respiratory,Distress Syndromes, Respiratory,Human ARDS,Lung, Shock,Respiratory Distress Syndromes,Syndrome, Respiratory Distress
D002614 Chelating Agents Chemicals that bind to and remove ions from solutions. Many chelating agents function through the formation of COORDINATION COMPLEXES with METALS. Chelating Agent,Chelator,Complexons,Metal Antagonists,Chelators,Metal Chelating Agents,Agent, Chelating,Agents, Chelating,Agents, Metal Chelating,Antagonists, Metal,Chelating Agents, Metal
D004113 Succimer A mercaptodicarboxylic acid used as an antidote to heavy metal poisoning because it forms strong chelates with them. DMSA,Dimercaptosuccinic Acid,2,3-Dimercaptosuccinic Acid,Butanedioic Acid, 2,3-Dimercapto-, (R*,S*)-Isomer,Chemet,Ro-1-7977,Succicaptal,Succimer Antimony Sodium Salt, (R*,S*)-Isomer,Succimer, (R*,R*)-(+,-)-Isomer,Succimer, Dipotassium Salt,Succimer, Disodium Salt,Succimer, Monosodium Salt,Succimer, Rhenium Salt,Succimer, Tin Salt,Tin Dimercaptosuccinate,meso-Dimercaptosuccinic Acid,2,3 Dimercaptosuccinic Acid,Acid, 2,3-Dimercaptosuccinic,Acid, Dimercaptosuccinic,Acid, meso-Dimercaptosuccinic,Dimercaptosuccinate, Tin,Dipotassium Salt Succimer,Disodium Salt Succimer,Monosodium Salt Succimer,Rhenium Salt Succimer,Ro 1 7977,Ro17977,Tin Salt Succimer,meso Dimercaptosuccinic Acid
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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