ACUTE MERCURY-POISONING BY INTENTIONAL INGESTION OF MERCURIC-CHLORIDE

A 26-year-old woman ingested 0.9 g of mercuric chloride in a suicide a ttempt and developed hematemesis, melena and acute renal failure. Anur ia persisted for 14 days. She was treated by plasma exchange, hemodial ysis and peritoneal dialysis in combination with continued dimercaprol chelation. While hemodialysis was ineffective in removing the mercury , plasma exchange effectively eliminated mercury. After two plasma exc hange therapies, mercury concentration in the blood decreased linearly on a log scale with half-lives of 23.1 days for whole blood and 19.1 days for plasma, using first-order kinetics. One month after ingestion , renal function recovered to normal as judged by serum creatine and b lood urea nitrogen levels, although the beta(2)-microglobulin level in urine was still elevated. At a follow-up examination four months late r, renal function was found to be completely normal. This indicates th at the renal damage caused by acute mercuric chloride poisoning may no t be permanent. (C) 1997 Tohoku University Medical Press.