Nephrotic syndrome following mercury vapor exposure

  3 out of 5 stars Mercury poisoning from home gold amalgam extraction. Saleem M et al.  Med J Aust 2013;199:125-127. No abstract available This case report describes a 62-year-old man who presented with flu-like symptoms and increasing shortness of breath. History revealed that he had recently attempted to extract gold from mercury-containing amalgam by heating the amalgam in a pan. As a result, he had been exposed to mercury fumes for approximately 3 hours. Workup revealed pneumonitis, as well as elevated blood and urine mercury levels. The patient was treated with chelation (DMSA) and steroids. One month later he returned with marked peripheral edema. Workup was diagnostic for severe nephrotic syndrome with a renal biopsy showing minimal change disease. After several months of chelation and adjunctive treatment, the patient’s renal and pulmonary function essentially returned to normal. In their discussion, the authors make the following points: Exposure to mercury vapor typically presents with flu-like symptoms followed by pulmonary toxicity. Renal involvement can include nephrotic syndrome, with renal biopsy showing membranous glomerulopathy or minimal change disease. It this case the authors speculate that chelation may have exacerbated the nephrotic syndrome by exposing the glomeruli to large amounts of mercury.
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical mercury toxicity mercury vapor nephrotic syndrome pneumonitis renal toxicity Source Type: news