Mercury intoxication presenting with hypertension and tachycardia

An 11 year old girl presented with hypertension and tachycardia. Excess uri nary catecholamine excretion suggested phaeochromocytoma but imaging studie s failed to demonstrate a tumour. Other symptoms included insomnia and weig ht loss, and she was found to have a raised concentration of mercury in blo od and urine. Mercury intoxication should be considered in the differential diagnosis of hypertension with tachycardia even in patients presenting wit hout the skin lesions typical of mercury intoxication and without a history of exposure.