A Case of Mercury Toxicity Complicated by Acute Inflammatory Demyelinating Polyneuropathy.

Journal of Child Neurology
Stacey EvansElena Caron

Abstract

A 13-year-old African American male presented with 2 months of subacute altered mental status, ptosis, areflexia, disordered gait, constipation, weight loss, abdominal and testicular pain, and hyperhidrosis. Initial workup at our facility was unrevealing until elevated serum mercury level was detected. Diagnosis of mercury toxicity was confirmed, and chelation therapy with succimer was started. After beginning succimer, the patient developed acute-onset weakness and was diagnosed with acute inflammatory demyelinating polyneuropathy. Supportive studies included elevated cerebrospinal fluid protein and acquired demyelinating polyneuropathy on nerve conduction study. He responded well to treatment with intravenous immunoglobulin and returned to his baseline state of health. Although there is a known association between mercury toxicity and axonal neuropathy, there is only 1 other case report of acute inflammatory demyelinating polyneuropathy in the setting of mercury toxicity. The nature of the correlation between these 2 entities in our case remains unclear.

References

Jan 12, 2012·Journal of Environmental and Public Health·Robin A Bernhoft
Dec 12, 2012·Journal of Preventive Medicine and Public Health = Yebang Ŭihakhoe Chi·Jung-Duck Park, Wei Zheng

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Citations

Sep 29, 2019·Journal of Child Neurology·Paolo D PigattoGianpaolo Guzzi
Apr 29, 2020·Rheumatology International·Mehmet YildizOzgur Kasapcopur
Mar 27, 2021·The Journal of International Medical Research·Chen YaweiHan Liping
Jan 11, 2022·Clinical Pediatrics·Karen S KimAnna Suessman

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