Toxicokinetics and toxicodynamics of elemental mercury following self-administration

Giuseppe De Palma, Orietta Mariotti, Davide Lonati, Matteo Goldoni, Simona Catalani, Antonio Mutti, Carlo Locatelli, Pietro Apostoli

Research output: Contribution to journalArticle

Abstract

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

Original languageEnglish
Pages (from-to)869-876
Number of pages8
JournalClinical Toxicology
Volume46
Issue number9
DOIs
Publication statusPublished - Nov 2008

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Keywords

  • Embolism
  • Intravenous
  • Mercury
  • Poisoning

ASJC Scopus subject areas

  • Toxicology

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