Department of Toxicology and Internal Medicine, Lower Silesia Specialist Hospital T. Marciniak in Wrocław, Fieldorfa 2, Wrocław, PL 54-049, Poland; Department of Pharmacology, Wroclaw Medical University, Jana Mikulicza-Radeckiego 2, Wrocław, PL 50-345, Poland.
Department of Pharmacology, Wroclaw Medical University, Jana Mikulicza-Radeckiego 2, Wrocław, PL 50-345, Poland.
J Forensic Leg Med. 2021 Feb;78:102129. doi: 10.1016/j.jflm.2021.102129. Epub 2021 Feb 5.
Mercuric chloride (mercury (II) chloride) belongs to inorganic mercury compounds characterized by good water solubility and associated high toxicity. The paper describes an unusual case of intranasal intoxication with corrosive sublimate confused with cocaine by a young male.
Intranasal administration of corrosive sublimate caused severe local symptoms of chemical burn within the nasal cavity. From the 2nd day the patient developed symptoms of renal dysfunction with transient polyuria and serum retention of nitrogen metabolites. The patient was undergoing chelation therapy with DMPS, N-acetylcysteine and d-penicyllamine. Four procedures of haemodialysis were performed with simultaneous DMPS and N-acetylcysteine treatment. The urine mercury level on the first day of hospitalization was 1989 μg/L, and after 26 days of treatment returned to the physiological level. During treatment renal function was normalized, the patient was discharged in general good condition.
Mercuric chloride is readily absorbed from the nasal cavity. Its administration may cause intoxication manifested by both chemical burn at the exposure site and systemic symptoms, particularly renal impairment. Even in case of renal dysfunction the use of DMPS seems safe, if haemodialysis is performed at the same time. Simultaneous haemodialysis and chelation therapy may accelerate elimination of mercury from the organism.
氯化汞（二氯化汞）属于无机汞化合物，具有良好的水溶性和高毒性。本文描述了 1 例年轻男性经鼻腔摄入腐蚀性升汞（与可卡因混淆）导致中毒的罕见病例。
腐蚀性升汞经鼻腔给药后，鼻腔内迅速出现化学灼伤的局部症状。第 2 天，患者出现肾功能障碍的症状，表现为一过性多尿和血清氮代谢物潴留。患者接受了二巯丁二酸（DMPS）、N-乙酰半胱氨酸和 D-青霉胺的螯合治疗。进行了 4 次血液透析，同时给予 DMPS 和 N-乙酰半胱氨酸治疗。患者入院第 1 天的尿汞水平为 1989μg/L，26 天后恢复至生理水平。在治疗过程中，肾功能恢复正常，患者一般情况良好出院。
氯化汞极易从鼻腔吸收。其摄入可引起中毒，表现为暴露部位的化学灼伤和全身症状，特别是肾功能损害。即使出现肾功能障碍，如果同时进行血液透析，使用 DMPS 似乎也是安全的。同时进行血液透析和螯合治疗可能会加速汞从体内的排出。
