Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury
We here report on a case of massive organic mercury intoxication in a 40-year-old man that resulted in progressive multiorgan failure. We treated the patient intravenously and enterally with the chelating agent (RS)-2,3-bis(sulfanyl) propane-1-sulfonic acid (DMPS) in addition to hemodialysis. The pa...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2019/4275918 |
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| author | L. C. Napp C. Moelgen F. Wegner P. Heitland H. D. Koester M. Klintschar M. Hiss A. Schaper B. Schieffer J. Bauersachs A. Schäfer J. Tongers |
| author_facet | L. C. Napp C. Moelgen F. Wegner P. Heitland H. D. Koester M. Klintschar M. Hiss A. Schaper B. Schieffer J. Bauersachs A. Schäfer J. Tongers |
| author_sort | L. C. Napp |
| collection | DOAJ |
| description | We here report on a case of massive organic mercury intoxication in a 40-year-old man that resulted in progressive multiorgan failure. We treated the patient intravenously and enterally with the chelating agent (RS)-2,3-bis(sulfanyl) propane-1-sulfonic acid (DMPS) in addition to hemodialysis. The patient was treated for 6 weeks and could successfully be weaned from mechanical ventilation and hemodialysis. He awoke and was sent to rehabilitation, but unfortunately died 7 months later from refractory status epilepticus. Autopsy revealed severe brain atrophy consistent with organ damage from massive mercury intoxication. The present case illustrates that bimodal DMPS application is sufficient for detoxification from lethal mercury levels, with an associated chance for weaning of organ support and survival to discharge. The case further reminds us of intoxication as a cause of multiorgan dysfunction. We propose to immediately initiate combined parenteral and enteral detoxification in cases of methyl mercury intoxication, especially in cases of high doses. |
| format | Article |
| id | doaj-art-7e800eb5f6864d44a02774d400ad71d9 |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-7e800eb5f6864d44a02774d400ad71d92025-02-03T01:29:23ZengWileyCase Reports in Critical Care2090-64202090-64392019-01-01201910.1155/2019/42759184275918Multimodal Elimination for Intoxication with a Lethal Dose of Organic MercuryL. C. Napp0C. Moelgen1F. Wegner2P. Heitland3H. D. Koester4M. Klintschar5M. Hiss6A. Schaper7B. Schieffer8J. Bauersachs9A. Schäfer10J. Tongers11Department of Cardiology and Angiology, Hannover Medical School, GermanyDepartment of Pneumology, Hannover Medical School, GermanyDepartment of Neurology, Hannover Medical School, GermanyMedical Laboratory Bremen, Bremen, GermanyMedical Laboratory Bremen, Bremen, GermanyDepartment of Legal Medicine, Hannover Medical School, GermanyDepartment of Nephrology, Hannover Medical School, Hannover, GermanyGIZ-Nord Poisons Centre, University Medical Centre Göttingen, GermanyDepartment of Cardiology, University Hospital Marburg, GermanyDepartment of Cardiology and Angiology, Hannover Medical School, GermanyDepartment of Cardiology and Angiology, Hannover Medical School, GermanyDepartment of Cardiology and Angiology, Hannover Medical School, GermanyWe here report on a case of massive organic mercury intoxication in a 40-year-old man that resulted in progressive multiorgan failure. We treated the patient intravenously and enterally with the chelating agent (RS)-2,3-bis(sulfanyl) propane-1-sulfonic acid (DMPS) in addition to hemodialysis. The patient was treated for 6 weeks and could successfully be weaned from mechanical ventilation and hemodialysis. He awoke and was sent to rehabilitation, but unfortunately died 7 months later from refractory status epilepticus. Autopsy revealed severe brain atrophy consistent with organ damage from massive mercury intoxication. The present case illustrates that bimodal DMPS application is sufficient for detoxification from lethal mercury levels, with an associated chance for weaning of organ support and survival to discharge. The case further reminds us of intoxication as a cause of multiorgan dysfunction. We propose to immediately initiate combined parenteral and enteral detoxification in cases of methyl mercury intoxication, especially in cases of high doses.http://dx.doi.org/10.1155/2019/4275918 |
| spellingShingle | L. C. Napp C. Moelgen F. Wegner P. Heitland H. D. Koester M. Klintschar M. Hiss A. Schaper B. Schieffer J. Bauersachs A. Schäfer J. Tongers Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury Case Reports in Critical Care |
| title | Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury |
| title_full | Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury |
| title_fullStr | Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury |
| title_full_unstemmed | Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury |
| title_short | Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury |
| title_sort | multimodal elimination for intoxication with a lethal dose of organic mercury |
| url | http://dx.doi.org/10.1155/2019/4275918 |
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