Clinical outcomes in inorganic mercury salts ingestions

• Published in: Journal of toxicology. Clinical toxicology Vol. 41; no. 5; p. 738
• Main Authors: Petrovski, D, Naumovski, J, Pereska, Z, Cibisev, A, Naumov, I, Licoska, F
• Format: Journal Article
• Language: English
• Published: 01.08.2003
• ISSN: 0731-3810

Ingestion of elemental mercury is generally not accompanied by major adverse effects. However, ingestion of inorganic mercury salts may cause severe gastrointestinal corrosion, renal failure and death, with acute lethal doses ranging from 1 to 4 g. We analyzed and present clinical material from nine patients, hospitally treated, after ingestion of various amounts of mercury chloride. All treated patients presented with upper gastrointestinal complaints and underwent endoscopies that showed caustic lesions in the upper gastrointestinum. Four of them (44%) had life-threatening upper gastrointestinal bleeding, along with numerous esophagus and stomach caustic lesions, and spread fibrinonecrotic plagues, deepest in the prepyloric region. Five (55%) of them developed acute renal failure. Four patients (44%) underwent dialysis. Antidotal therapy was given to two patients only, because of unreadily availability or lack of opportune timing. The overall lethal outcome of the group was 3 (33%) even after dialysis, antidote administration, and conservative treatment for the upper gastrointestinal injuries. Inorganic mercury salts ingestions present with a broad spectrum of fast-developing clinical impairments, have various and often poor clinical outcomes. Our clinical experience emphasizes preparedness to administer on-time, multifaceted/combined treatment, including antidotal, dialysis, and other approaches in all suspected cases.