Nefropatía membranosa secundaria a exposición laboral con mercurio metálico

Las nefropatías tóxicas secundarias a la exposición ocupacional a metales han sido ampliamente estudiadas. La nefropatía membranosa por mercurio es poco frecuente.La intoxicación ocupacional con mercurio sí es frecuente, siendo las principales formas de presentación las manifestaciones clínicas neurológicas. La afectación renal secundaria a la exposición crónica a mercurio metálico puede desarrollar enfermedad glomerular por depósito de inmunocomplejos. La glomerulopatía membranosa y a cambios mínimos son las más frecuentemente comunicadas.Se presenta el caso de un paciente con exposición ocupacional a mercurio metálico, con síndrome nefrótico y biopsia renal con glomerulopatía membranosa que presentó respuesta favorable luego del tratamiento quelante e inmunosupresor.

Toxic nephrophaties secondary to occupational exposure to metals have been widely studied, including membranous nephropathy by mercury, which is rare. Occupational poisoning by mercury is frequent, neurological symptoms are the main form of clinical presentation. Secondary renal involvement in chronic exposure to metallic mercury can cause glomerular disease by deposit of immune-complexes. Membranous glomerulopathy and minimal change disease are the most frequently reported forms. Here we describe the case of a patient with occupational exposure to metallic mercury, where nephrotic syndrome due to membranous glomerulonephritis responded favorably to both chelation and immunosuppressive therapy.

Occurrence of Cognitive and Neurological Symptoms in Norwegian Dentists

OBJECTIVES: Previous investigations have presented some evidence of late cognitive effects in dental personnel exposed to metallic mercury. We wanted to examine if Norwegian dentists have an increased prevalence of symptoms consistent with neurological and/or cognitive malfunction. METHODS: The study group consisted of 406 dentists from central Norway and 217 controls from the general population, all under the age of 70. They had responded to a standardised postal questionnaire (Euroquest) inquiring about seven symptoms in regard to neurology, psychosomatics, memory, concentration, mood, sleep disturbances, and fatigue. A score was calculated for each symptom based on 4 to 15 single questions scored on a scale from 1 (seldom or never) to 4 (very often). RESULTS: The dentists and controls had a participation rate of 57.2% and 42.9% respectively. The dentists reported no more cognitive symptoms than the controls, with low average symptom scores from 1.16 for neurological symptoms in males to 1.73 for fatigue in females. Corresponding figures for the controls were 1.22 and 1.77. There were a total of 1.2% of the dentists and 1.8% of the controls who reported having three or more of the seven symptoms "often" or more frequently. CONCLUSION: Norwegian dentists do not report more cognitive and neurological symptoms than controls from the general population.

Subcutaneous and Gastrointestinal Exposure to Metallic Mercury: Report of 2 Cases / 대한산업의학회지

BACKGROUND: Mercury poisoning presents a variety of clinical pictures depending on the chemical structure, the route of exposure, the amount absorbed and other individual factors. Therefore, the ingestive and subcutaneous absorption of elemental(metallic) mercury can be considered to be relatively harmless in contrast to the inhalation of mercury vapor. CASE REPORTS: A 72-year-old man presented to the department of urology due to tenderness, edema and a necrotic abscess of his penis after trauma. The soft tissue abscess required a surgical resection of the penis. For chelation therapy, oral D-penicillamine was administrated. 7 months later, he showed no subjective or objective signs of mercury poisoning. Another 5-yearold girl presented to the emergency department after accidental self-ingestion of elemental mercury. She was followed clinically and did not show any systemic mercury poisoning. CONCLUSION: The Mercury concentrations in the blood and urine were elevated in the case of subcutaneous exposure, but was unchanged in the case of ingestion. Subcutaneous and gastrointestinal exposure to metallic mercury has a minimal risk for systemic mercury poisoning, which is in contrast to the exposure by inhalation.

Evaluation of Mercury Concentration in Spot Urine for Biological Monitoring Among Metallic Mercury Exposed Workers / 대한산업의학회지

Biological monitoring for exposures permits estimation of organ doses or body burdens from exposures through all relevant portals of entry. Biological monitoring data may be used to estimate environmental concentrations when the latter cannot be measured directly. Biological indices are usually surrogates for the concentration of a chemical or its metabolites or its effect at the true receptors. Mercury concentration in urine has-been most-coinmoialy-recommended as a biological exposure index of mercury. For data based on urine analysis, variation in urine volume is the most significant. The urinary concentration related to excretion of the solute provides some correction for fluctuation of urine output. Sampling time must be carefully observed because distribution and elimination of a chemical are kinetic events. This study has evaluated mercury concentration in spot urine compared to the results of 24 hour collected urine by the adjustment methods (specif ic gravity, creatinine) and sampling time. The subjects were 43 workers who had been exposed to the metallic mercury. The results were as follows: 1. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0.639-0.715 and were not different by adjustment methods. 2. In the high exposure group who were over lOOug/1 of urinary mercury, the correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0. 687-0.824 and were not different by adjustment methods. 3. Mercury concentration in spot urine were very variable by sampling time or exposure time. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were most highest as 0.85-0.91 at first voiding urine in the morning, and were 0. 77-0.86 at urine collected within four hours before end of shift. In the biological monitoring to exposure of mercury, sampling of spot urine were most proper at first voiding urine in the morning, and then at urine collected within four hours before end of shift. But the adjustment methods of specific gravity and creatinine were no difference of the results.