Wang Zhongying, Fang Xiang
Medicine, Heze Medical College, Heze, CHN.
Neurology, University of Texas Medical Branch, Galveston, USA.
Cureus. 2021 Nov 26;13(11):e19916. doi: 10.7759/cureus.19916. eCollection 2021 Nov.
Chronic mercury poisoning from cosmetics is often misdiagnosed and mistreated due to atypical clinical presentations and high industrial standards and quality control of cosmetic products. Here we present a case of a 45-year-old female with a four-month history of progressive weakness, atrophy, insomnia, mood swings, chorea-like movement, extremity pain and hyperalgesia. The routine workup for neuropathy and myopathy such as CK, EMG were unremarkable. However heavy metal screen revealed significantly elevated mercury levels. Afterwards, we found it was caused by daily-use whitening cosmetics through the hair segmented toxicant analysis to trace the dynamics changing of mercury concentration in the body. After the removal of the patient from the source of exposure, and chelation therapy, her symptoms had gradually improved. When patients have unexplained behavioral changes, cognitive decline, sleep disturbance, fatigue, pain, and other unspecific manifestations, the possibility of mercury poisoning should be considered, blood mercury and urine mercury should be detected, and the source of exposure should be investigated and timely treatment should be given.
由于临床表现不典型以及化妆品行业标准和质量控制较高,化妆品导致的慢性汞中毒常被误诊和误治。在此,我们报告一例45岁女性病例,该患者有四个月进行性肌无力、萎缩、失眠、情绪波动、舞蹈样动作、肢体疼痛和痛觉过敏病史。针对神经病变和肌病的常规检查,如肌酸激酶(CK)、肌电图(EMG)均无异常。然而,重金属筛查显示汞水平显著升高。随后,通过头发分段毒物分析追踪体内汞浓度的动态变化,我们发现这是由日常使用的美白化妆品所致。在让患者脱离暴露源并进行螯合治疗后,她的症状逐渐改善。当患者出现无法解释的行为改变、认知下降、睡眠障碍、疲劳、疼痛及其他非特异性表现时,应考虑汞中毒的可能性,检测血汞和尿汞,调查暴露源并及时给予治疗。