HYPERTENSIVE ENCEPHALOPATHY INDUCED BY MERCURY POISONING; A REPORT OF 3 CASES (IN AN IRANIAN FAMILY)

Objective

Mercury poisoning is one of the important recent causes of mortality and mortality in children worldwide, particularly in industrial environments; mercury is a poisonous metal, especially harmful to the nervous and immune systems and the kidneys and can even be fatal. Elemental mercury is present in thermometers, barometer batteries, sphygmomanometers and latex paints.

Inorganic mercury salts are found in antiseptics, pesticides, pigments and explosives and are used as preservatives in medicine. Mercury was once used to stop fever, and this worked because the immune system was so weakened that it could no longer sustain the attack for which the fever was created. Some medical drugs still contain mercury chloride and mercurous chloride and certain forms of mercury are still used in some laxatives. Mercury toxicity of the nervous system causes anorexia, ataxia, lack of ability to coordinate voluntary muscle movements, dementia, depression, dizziness, emotional instability, erethism (abnormal irritability in response to stimulation), incoordination, insomnia, irritability, loss of ability to speak, memory impairment, numbness, saresthesias (sensation of prickling, tingling or creeping on the skin), psychosis, tremors, drowsiness, fatigue and weakness.

Other organ damages include kidney failure, headaches, hearing impairment, visual impairment, hypertension, dermatitis, digestive tract problems, colitis, diarrhea, stomatitis and excessive salivation, loss of teeth, metallic taste, chromosomal damage, birth defects and ensuing organ failure. Chronic mercury poisoning can cause Acrodynia (Pink disease). Mercury poisoning is a rare cause of hypertension in children. Herein we report 3 cases, the first a child with hypertensive encephalopathy due to severe mercury poisoning and his two siblings with moderate symptoms.

Case report

A 10 year old boy was admitted in psychiatric ward of Imam Hossein Hospital with behavioral disorder, irritability, mood change and convulsion. Because of his blood pressure which was 160/120 he was referred and admitted to the Pediatric Nephrology department. On arrival, for his hypotonia and the pink discoloration of his fingers a diagnosis of Acrodynia (Pink disease) was considered; his history showed that he has played with a ball of mercury, taken from a laboratory. He and his 2 siblings received British Anti Lewisite(BAL) and D-penicillamin; at follow-up all symptoms had gradually disappeared and they are well now.