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Vinupriya S, Gopala krishnan K, Shivapriya R, Arasu PS, Kumar SA, Vijayanarayanan A, Shankar A. Factitialpanniculitis secondary to injected subcutaneous elemental mercury- a case report. JAAD Case Rep 2022; 21:154-156. [PMID: 35242970 PMCID: PMC8866902 DOI: 10.1016/j.jdcr.2022.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yildiz M, Adrovic A, Gurup A, Karabag Yilmaz E, Ozer Y, Koker O, Sahin S, Kiykim E, Canpolat N, Barut K, Kasapcopur O. Mercury intoxication resembling pediatric rheumatic diseases: case series and literature review. Rheumatol Int 2020; 40:1333-1342. [PMID: 32342181 DOI: 10.1007/s00296-020-04589-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/18/2020] [Indexed: 11/29/2022]
Abstract
Mercury is the only metal that remains in liquid form at the room temperature. It is a very toxic metal and even short-term exposure can lead to poisoning. Mercury intoxication can affect many systems such as skin, cardiovascular, genitourinary, central and peripheral nervous, respiratory, and musculoskeletal system. Consequently, the diagnosis of mercury intoxication can be challenging due to its non-specific and multisystemic presentation. Herein, we report five pediatric cases with mercury intoxication from two families that were initially misdiagnosed as rheumatic disorders. We also performed a literature review about pediatric cases with mercury intoxication to investigate the clinical findings in children, the source of intoxication, and the current treatment preferences. As in our cases, reported patients were previously misdiagnosed as various infectious and/or rheumatic diseases before the diagnosis of mercury intoxication was established. A delay in diagnosis and treatment can cause serious morbidities and even mortality. We report this case series to emphasize the multisystemic presentation of mercury intoxication, and to remind and provide clues for physicians to recognize this rare toxicologic syndrome.
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Affiliation(s)
- Mehmet Yildiz
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Amra Adrovic
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Aybuke Gurup
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Esra Karabag Yilmaz
- Cerrahpasa Medical School, Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Yavuz Ozer
- Cerrahpasa Medical School, Department of Pediatric Endocrinology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Oya Koker
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sezgin Sahin
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ertugrul Kiykim
- Cerrahpasa Medical School, Department of Nutrition and Metabolism, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nur Canpolat
- Cerrahpasa Medical School, Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Kenan Barut
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozgur Kasapcopur
- Cerrahpasa Medical School, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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Kim D, Park JW. Metallic Mercury Injection in the Hand Caused by A Broken Mercury Thermometer: A Case Report. J Hand Surg Asian Pac Vol 2017; 22:519-522. [PMID: 29117841 DOI: 10.1142/s0218810417720376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Incorrect usage of or accidents related to metallic mercury can be hazardous. Herein, we present a case of subcutaneous metallic mercury injection in the hand caused by a broken thermometer and surgical tips for this injury. A 43-year-old female patient visited our hospital due to mercurial injection injury at the left hand suffered 4 weeks previously. On gross findings, the mercury deposition was limited to the subcutaneous layer and enveloped by granulation tissue. The blood mercury level, which had been abnormally elevated, fortunately decreased to within normal levels within five months. Nonetheless, this initial elevation indicates the possibility of systemic complications after local absorption of mercury droplets into the general circulation. In conclusion, we recommend prompt and complete excision of mercury material to prevent local and systemic complications, and excising the granulation tissue in its entirety, while retaining the mercury droplets within, is recommended.
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Affiliation(s)
- Dongmin Kim
- 1 Department of Orthopedic Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Jong Woong Park
- 1 Department of Orthopedic Surgery, College of Medicine, Korea University, Seoul, Korea
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Thanuja Nilushi Priyangika SM, Karunarathna WGSG, Liyanage I, Gunawardana M, Dissanayake B, Udumalgala S, Rosa C, Samarasinghe T, Wijesinghe P, Kulatunga A. A rare case of self-injection of elemental mercury. BMC Res Notes 2016; 9:189. [PMID: 27012667 PMCID: PMC4807590 DOI: 10.1186/s13104-016-1992-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/15/2016] [Indexed: 11/18/2022] Open
Abstract
Background Self-injection of elemental mercury is a rare finding especially in healthy people who are mentally sound. Early detection and removal of mercury from the body by chelation and physical removal of a stored injected site is required to prevent long term toxicity. Case presentation A 15 year old previously healthy girl presented with an acute febrile illness with a generalized maculopapular skin rash for 3 days with a preceding history of self-injection of mercury to both her forearms. This was an imitating experimental act influenced by a movie and she was mentally sound. Very high whole blood mercury levels, x-rays of the forearms and histology confirmed mercury poisoning. Conclusion Self-injection of elemental mercury can also occur in mentally sound people and rapid diagnosis and decontamination is required. This also signifies the importance of imposing limitations for visual media which could misguide minors and lead those to imitate and cause serious self-harm.
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Affiliation(s)
| | | | | | | | | | | | - Chamith Rosa
- National Hospital of Sri Lanka, Colombo, Sri Lanka
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