Edgar-Whelan Harry, Fish Eleanor, Pyae Phyoe Kyaw, Ghani Hakim, Vancheeswaran Rama
Acute Medicine, Watford General Hospital, Watford, GBR.
Acute Medicine, University College London Medical School, London, GBR.
Cureus. 2025 Jun 22;17(6):e86514. doi: 10.7759/cureus.86514. eCollection 2025 Jun.
We present a case of a patient known to have rheumatoid arthritis with severe nephrotic syndrome very likely due to chronic mercury poisoning. She was known to have rheumatoid arthritis for 10 years. Mercury poisoning was attributed to homeopathic Ayurvedic medicine which she took for arthritic pain. It is highly likely that the Ayurvedic medications contained high concentrations of mercury. The patient presented with worsening breathlessness on exertion and global pitting oedema. Initial investigations suggested a nephrotic syndrome of unknown aetiology. The patient's kidney function worsened, and she developed a hospital-acquired infection and deteriorated further with type 1 respiratory failure. Despite attempted continuous veno-venous hemodiafiltration, the patient unfortunately passed away secondary to end-stage renal failure caused by chronic severe mercury poisoning. This case report adds to the concerns regarding the potential risks of unregulated Ayurvedic medications without clear instructions from a trained medical professional. It highlights the importance of taking a detailed drug history on the first encounter with the patient.
我们报告一例已知患有类风湿性关节炎的患者,其患有严重肾病综合征,很可能是由于慢性汞中毒所致。她患类风湿性关节炎已有10年。汞中毒归因于她为缓解关节炎疼痛而服用的顺势疗法阿育吠陀药物。极有可能这些阿育吠陀药物含有高浓度的汞。患者出现活动时呼吸困难加重和全身性凹陷性水肿。初步检查提示病因不明的肾病综合征。患者肾功能恶化,发生医院获得性感染,并因1型呼吸衰竭进一步恶化。尽管尝试进行持续静脉-静脉血液透析滤过,但患者不幸因慢性重度汞中毒导致的终末期肾衰竭而死亡。本病例报告增加了人们对未经受过专业医学培训人员明确指导的阿育吠陀药物潜在风险的担忧。它强调了在首次接诊患者时详细询问用药史的重要性。