Understanding the Dangers of Mercury Poison

Mercury, a naturally occurring heavy metal, is widely used in various industries and household settings. However, its toxicity cannot be underestimated, and mercury poisoning can have devastating consequences. In this article, we will explore the different forms of mercury, their effects on the body, and three real-life cases that highlight the varying presentations and outcomes of mercury poison.

Mercury exists in three chemical forms: elemental (Hg0), inorganic mercurous (Hg+) or mercuric (Hg++) salts, and organic compounds. Each form has its own unique characteristics and effects on the human body. Elemental mercury is usually not absorbed from the gastrointestinal tract, but it can still cause harm through inhalation or skin contact.

The clinical manifestations of mercury poisoning vary greatly depending on the chemical form, dose, rate, and route of exposure. Common circumstances of exposure include recreational substance use, suicide or homicide attempts, occupational hazards, traditional medicines, and endemic food ingestions. For instance, the public health disasters in Minamata Bay, Japan, and Iraq serve as stark reminders of the devastating consequences of mercury poisoning.

In our analysis of patients admitted to a tertiary care referral center between August 2019 and August 2021, we identified 22 cases of mercury exposure, with three representative cases being discussed in detail. Case 1 involved a 3.5-year-old girl who ingested an elemental-mercury thermometer, resulting in elevated 24-hour urine mercury levels and nodular biopsy suggestive of mercury granulomas. Case 2 was a 27-year-old lady who developed multiple linear nodules on her upper limbs after receiving a red intravenous injection for anemia.

In both cases, the patients were treated with chelation therapy using oral dimercaptosuccinic acid (DMSA). Imaging revealed metallic-density deposits in viscera and bones. In Case 3, a patient presented with radiodense material in their stomach after ingesting a thermometer.

Our study highlights the marked variations observed in clinical manifestations and long-term outcomes among poisoned patients based on differences in chemical forms and routes of exposure to mercury. Additionally, we found that screening for serum voltage-gated potassium ion channels (VGKC)-contactin-associated protein-like 2 (CASPR2) antibodies was an important diagnostic tool.

In conclusion, mercury poisoning is a serious public health concern that requires immediate attention. It is essential to educate the public about the dangers of mercury exposure and to implement measures to prevent accidental ingestion or inhalation. Furthermore, healthcare providers must be aware of the varying presentations and outcomes of mercury poisoning to provide effective treatment and management strategies.

By understanding the risks associated with mercury poison, we can work towards reducing its impact on human health and preventing devastating consequences for individuals affected by this toxic substance.

Mercury poison