Acute mercuric chloride poisoning at a potentially lethal dose ended with survival: symptoms, concentration in cerebrospinal fluid, treatment

• Authors: Anna Krakowiak , Beata Janasik , Łukasz Sadowski , Katarzyna Szwabe , Waldemar Machała

Abstracts

EN

This study aims to present a case of acute mercuric chloride poisoning at a potentially lethal dose treated with the antidote – 2,3-dimercapto- 1-propanesulfonic acid (DMPS) and continuous renal replacement therapy (CRRT) combined with CytoSorb. A 21-year-old woman was admitted to a hospital with abdominal pain, vomiting, and suspected gastrointestinal bleeding after taking 5000 mg of mercuric chloride for suicidal purposes. Due to the patient deteriorating general condition and multiple organ damage, on the third day she was transported to the Clinic of Anaesthesiology and Intensive Care (CAaIC), Łódź, Poland. Laboratory tests confirmed features of acute kidney injury and high mercury levels in the blood (1051 μg/l) and urine (22 960 μg/l) – DMPS therapy and CRRT combined with CytoSorb were instituted. Due to nervous system complaints (headache, dizziness), a lumbosacral puncture was performed – the mercury concentration in the cerebrospinal fluid (CSF) was 5.45 μg/l. During a colonoscopy, significant diagnostic abnormalities revealed features of colonic mucosal necrosis. The treatment resulted in a decrease in subjective complaints, decreased mercury levels in biological material, and improved parenchymal organ function. On the 15th day of therapy, the patient was transferred to the primary care center for further treatment. The case confirms the possibility of improvement of patient condition following ingestion of a potentially lethal dose (5 g) as a result of the initiation of appropriate therapy even on the third day. The presence of mercury in CSF confirms that inorganic mercury compounds (mercuric chloride) can pass through the blood-brain barrier after oral ingestion.

Keywords

EN

necrotizing enterocolitis; renal failure; continuous renal replacement therapy; mercuric chloride poisoning; Hg concentration in cerebrospinal fluid; dimercaptopropanesulfone

• Publisher: Instytut Medycyny Pracy im. prof. dra Jerzego Nofera w Łodzi
• Journal: International Journal of Occupational Medicine and Environmental Health
• Year: 2023
• Volume: 36
• Issue: 5
• Pages: 685-692

Dates

published

2023

Contributors

author

Anna Krakowiak

• Central Clinical Hospital of the Medical University of Łódź, Łódź, Poland (Clinic of Anaesthesiology and Intensive Care)
• Nofer Institute of Occupational Medicine, Łódź, Poland (Centre for Physicians Training in Public Health)

author

Beata Janasik

• Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Biological and Environmental Monitoring)

author

Łukasz Sadowski

• Central Clinical Hospital of the Medical University of Łódź, Łódź, Poland (Clinic of Anaesthesiology and Intensive Care)

author

Katarzyna Szwabe

• Medical University of Łódź, Łódź, Poland (Department of Laboratory Diagnostics and Clinical Biochemistry)
• Central Clinical Hospital of Medical University of Łódź, Łódź, Poland (Medical Diagnostic Laboratory)

author

Waldemar Machała

• Central Clinical Hospital of the Medical University of Łódź, Łódź, Poland (Clinic of Anaesthesiology and Intensive Care)

Identifiers

DOI

10.13075/ijomeh.1896.02235

Biblioteka Nauki

21375385