Acrodynia and hypertension in a young girl secondary to elemental mercury toxicity acquired in the home.

Acrodynia, also known as pink disease, erythredema polyneuropathy, Feer syndrome, and raw-beef hands and feet, is thought to be a toxic reaction to elemental mercury and less commonly to organic and inorganic forms. Occurring commonly in the early 20th century, acrodynia is now a seemingly extinct disease in the modern world because of regulations to eliminate mercury from personal care products, household items, medications, and vaccinations. We present a case of a 3-year-old girl with acrodynia secondary to toxic exposure to elemental mercury in the home environment.

Metal mercury poisoning in two boys initially treated for brucellosis in Mashhad, Iran.

Elemental mercury (Hg) is the only metal which evaporates in room temperature and its inhalation may cause toxicity. Hg poisoning may occur by mishandling the metal, particularly in children who play with it. Wide-spectrum of the clinical presentations of chronic Hg poisoning may cause misdiagnosis, particularly when history of exposure is unknown. We report two cases of accidental Hg poisoning, which initially had been diagnosed and treated for brucellosis. The patients were two brothers (7 and 14 years old) who presented with pain in their lower extremities, sweating, salivation, weight loss, anorexia and mood changes on admission. Meticulous history taking revealed that they had played with a ball of Hg since 3 months before admission. The level of urinary Hg was 125.9 and 54.2 9 g/L in the younger and older brother, respectively (normal ≤25 g/L). The patients were successfully treated by dimercaprol and discharged in good condition 24 days after admission. These cases are being reported to emphasize the importance of acrodynia as a differential diagnosis for brucellosis in endemic areas.

A Child with elemental mercury poisoning and unusual brain MRI findings.

Mercury vapor poisoning is a serious and potentially fatal problem. Neurological manifestations involving the central nervous system are seen with chronic mercury intoxication. We present the case of a 10-year-old child who demonstrated acrodynia, seizures, and visual impairment following 20 days of exposure to elemental mercury at home. The initial blood mercury concentration was 27.7 microg/L (normal <2 microg/L) and the initial 24-hour urine mercury concentration was 34.4 microg/L (normal =10 microg/L). After 9 months of treatment with D-penicillamine, the patient's clinical condition, biochemical laboratory parameters, and mercury concentrations all returned to normal. The T2-weighted MRI images of the patient's brain initially showed multiple hyperintense lesions in cerebral white matter, left globus pallidus, and putamen, which also improved.

Nifedipine in the treatment of acrodynia.

A case of acrodynia in an eight-and-a-half-year-old girl is presented whose symptoms--profuse perspiration, swelling, desquamation, pain, itching of the extremities, pinkish color of the nose and cheeks and hypertension--responded sharply to nifedipine therapy.

[Induction of acrodynia by grain preservative (author's transl)]. / Auslösung einer Akrodynie durch Aufnahme von Saatbeizmitteln

A five year old boy suffered from acrodynia induced by the ingestion of the mercury containing compound Ceresan-Morkit. Mercury was traced in blood and urine. Since the excretion of the 17-Ketosteroids was augmented, we treated the patient with cortison, cuasing a prompt improvement of the condition.