Schwartz J G, Snider T E, Montiel M M
Department of Pathology, University of Texas Health Science Center, San Antonio 78284-7750.
Am J Emerg Med. 1992 May;10(3):258-61. doi: 10.1016/0735-6757(92)90221-I.
A family of four developed toxic blood levels of mercury after the mother vacuumed a spilled jar of liquid mercury from a closet in their apartment. The youngest son developed severe thrombocytopenia which was initially diagnosed as idiopathic thrombocytopenic purpura secondary to viral illness. A possible association between acute mercury toxicity and idiopathic thrombocytopenic purpura has not been previously reported. Chelation therapy with penicillamine for the older child was administered soon after toxic blood mercury levels were known by the physician. Because thrombocytopenia has been reported to occur in up to 5% of patients receiving penicillamine therapy, the younger child was treated with dimercaptosuccinic acid. The mother was also treated with dimercaptosuccinic acid. The father received dimercaprol therapy. The toxic effects and rationale for now outdated therapeutic uses of mercury are discussed.
一名母亲在公寓壁橱中清理了一罐洒出的液态汞后，一家四口血液汞含量达到中毒水平。最小的儿子出现严重血小板减少症，最初被诊断为继发于病毒感染的特发性血小板减少性紫癜。急性汞中毒与特发性血小板减少性紫癜之间的可能关联此前尚未见报道。医生得知年长儿童血液汞中毒水平后，很快就对其采用青霉胺进行螯合治疗。由于据报道，接受青霉胺治疗的患者中高达5%会出现血小板减少症，年幼的孩子则用二巯基丁二酸进行治疗。母亲也接受了二巯基丁二酸治疗。父亲接受了二巯丙醇治疗。文中还讨论了汞的毒性作用以及现已过时的汞治疗用途的理论依据。
