Mercury poisoning with acute kidney injury

AUTHORS : Sharma Manjuri, Mahanta Arunima, Das Himanab Jyoti, Baruah Swaroop Kumar
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Exposure to inorganic mercury or mercuric salt can occur as an occupational hazard or suicidal attempt and can cause vomiting, severe abdominal pain, gastrointestinal bleeding, hypovolemic shock and renal tubular necrosis leading to oliguria or anuria. Hemodialysis is used in severe cases of toxicity when renal function has declined. This report aims at highlighting the clinical presentation and course of a case of mercuric poisoning who was treated with hemodialysis. This article reports a case of mercury poisoning whose renal failure improved with high flux hemodialysis. A 25 years old girl ingested a heavy metal compound containing Mercuric chloride obtained from her place of work in a deliberate suicidal attempt, following which she developed massive hematemesis, hypotension and developed renal failure with anuria. She was treated with broad spectrum antibiotics, IV pantoprazole and high flux hemodialysis. Renal biopsy was suggestive of acute tubular necrosis. After 7 hemodialysis her urine output began to improve and dialysis was stopped. Her renal function gradually improved and her blood mercury level also decreased. We have here by presented a case of mercury intoxication with acute tubular necrosis in a 25-year old woman, with an excellent improvement of the renal failure and normalization of laboratory results with high flux hemodialysis.

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