Is Chelation Therapy Efficient for the Treatment of Intravenous Metallic Mercury Intoxication?

0474993 - ÚFCH JH 2018 RIV US eng J - Článek v odborném periodiku
Pelclová, D. - Vlčková, Š. - Bezdíček, O. - Vaněčková, M. - Urban, P. - Ridzoň, P. - Diblik, P. - Navrátil, Tomáš - Klusáčková, P. - Vlček, K. - Benešová, O. - Třeštík, P. - Homolka, J. - Zakharov, S.
Is Chelation Therapy Efficient for the Treatment of Intravenous Metallic Mercury Intoxication?
Basic & Clinical Pharmacology & Toxicology. Roč. 120, č. 6 (2017), s. 628-633. ISSN 1742-7835. E-ISSN 1742-7843
Institucionální podpora: RVO:61388955
Klíčová slova: elemental mercury * injection * children
Obor OECD: Physical chemistry
Impakt faktor: 2.659, rok: 2017
Způsob publikování: Open access

The efficacy of treatment for intravenous elemental mercury intoxication has not been fully studied with regard to clinical outcome, and treatment recommendations vary. We treated a 41-year-old man with a history of drug abuse and depression who attempted suicide using 1 mL (13.53 g) metallic Hg i.v. He was admitted to the hospital 2 months later for dyspnoea and thoracic pain and was diagnosed with pneumonia. Hg deposits were seen in the lungs and extra-pulmonary organs. His blood level (372 g/L) exceeded the population level of 5 g/L by more than 70 times. Dimercaptopropane sulphonate sodium (DMPS, 600 mg/day orally) was administered for 14 days. One year later, the patient presented with dyspnoea on exertion, fatigue, depression and impaired sleep. His chest X-ray showed multiple opacities (size up to 2.8 cm), and psychological testing revealed a selective cognitive deficit in the area of visual attentiveness, flexibility, source memory and impairment of the motor speed of the dominant upper extremity. Mercury blood level was 158 g/L and mercury urine output was 1380 g/24 hr. DMPS (800 mg/day orally) was administered for 40 days. The patient eliminated up to 18 mg Hg/day. His Hg blood level and Hg urine output belong to the highest among reported cases. In spite of the therapy, the patient's blood Hg, complaints and psychological tests showed no improvement. This case report confirms that DMPS does not effectively remove intravenous deposits of metallic Hg.
Trvalý link: http://hdl.handle.net/11104/0271880