In the January/February issue of BCMJ, an interesting case of self-induced mercury poisoning was described. Dr Albrecht outlined elegantly the assistance of the BC Poison Control Centre in the confirmation of the diagnosis and the institution of chelating therapy. He subsequently used the case as a teaching tool for medical students.
As for the diagnosis, it was provided by the patient in the form of a handwritten letter. In hindsight, the radiodense globules in the region of the stomach and the hepatic flexure of the colon shown in a chest PA view were felt to indicate heavy metal ingestion.
As for teaching purposes, sources of mercury poisoning in other cases should include fish consumption, complementary and alternative medicines including Chinese herbal medicines, and Ayurvedic medicines, and others.
The author reported in a patient with mercury poisoning presented with generalized dermatitis and abnormal liver function similar to the present case. On the other hand, the prevalence of liver disease in a population from Minamata area (organic methyl mercury poisoning) was not increased compared with unexposed controls.
Dr Albrecht’s case illustrates a multifaceted presentation of mercury poisoning.
—H.C. George Wong, MD
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2. Copes R, Palaty J, Lockitch G. Mercury exposure in British Columbia: Do we have a problem? BC Med J 2004;46:390.
3. Wong HCG. Mercury and Chinese herbal medicine. BC Med J 2004;46:440.
4. Gair R. Heavy metal poisoning from Ayurvedic medicines. BC Med J 2008;50:105.
5. Brodin E, Copes R, Mattman A, et al. Lead and mercury exposures: Interpretation and action. CMAJ 2007;176:59-63.
6. Wong HCG. Acute generalized maculopapular eruption, abnormal liver function and elevated blood mercury level associated with Chinese herbal medicine. Can J Allergy Clin Immunol 2002;7:92-96.
7. Futusuka M, Kitano T, Nagano M, et al. An epidemiological study with risk analysis of liver diseases in general population living in a methylmercury polluted area. J Epidemiol Community Heath 1992;46:237-240.
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