MERCURY KINETICS IN A CASE OF SEVERE MERCURIC-CHLORIDE POISONING TREATED WITH DIMERCAPTO-1-PROPANE SULFONATE (DMPS)

1 A case of severe mercuric chloride poisoning with clinical signs of mucosal damage of the gastrointestinal tract and anuric renal failure, is presented. The initial whole blood mercury concentration was 14,30 0 mug l-1. This concentration is supposed to be associated with fatal outcome due to multiple organ failure. 2 Because of anuric renal failu re, haemodialysis was necessary. Kidney function returned to normal wi thin 10 days. Haemodialysis proved to be ineffective with regard to to tal mercury elimination, 3 Treatment with DMPS was started because of very severe poisoning, anuric renal failure and optimistic reports on the 'new' chelating agent 2,3-dimercapto-1-propanesulphonic acid (DMPS ) in mercury poisoning. DMPS was administered by parenteral route init ially and was continued thereafter by oral route, until whole blood an d urine mercury concentrations had decreased below a level considered as toxic. Except for a temporary pruritic erythema of the skin, no sid e effects of DMPS treatment were observed, 4 The clinical course was m ild, despite continuing high whole blood mercury concentrations. Recov ery was uneventful and complete, DMPS treatment, administered by intra venous and oral route, was shown to be an effective alternative for BA L in life-threatening mercuric chloride intoxication. 5 The pharmacoki netic data presented in this case report suggest that non-renal mercur y clearance may considerably exceed renal mercury clearance.