Clinical course of severe poisoning with thiomersal.
A 44-year-old man ingested 83 mg/kg Thiomersal. He developed gastritis, renal tubular failure, dermatitis, gingivitis, delirium, coma, polyneuropathy and respiratory failure. Treatment was symptomatic plus gastric lavage and the oral chelating agents dimercaptopropane sulfonate and dimercaptosuccinic acid. The patient recovered completely. Maximum mercury concentrations were blood 14 mg/L, serum 1.7 mg/L, urine 10.7 mg/L, and cerebrospinal fluid 0.025 mg/L. Mercury concentration in blood declined with two velocities: first with half-time 2.2 days, then with half-time 40.5 days. The decline of mercury concentration in blood, urinary mercury excretion, and renal mercury clearance were not substantially influenced by chelation therapy.
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Walther-Straub-Institut für Pharmakologie und Toxikologie, Universität München, Germany.
Mückter
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Roider
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Zilker
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D000284:Administration, Oral; D000328:Adult; D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000506:poisoning*; D002614:Chelating Agents / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007928:Lethal Dose 50; D008297:Male; D008628:Mercury / Q000097:blood / Q000134:cerebrospinal fluid / Q000652:urine; D051381:Rats; D004113:Succimer / Q000627:therapeutic use; D013406:Suicide, Attempted; D013849:Thimerosal / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000506:poisoning* / Q000633:toxicity; D014494:Unithiol / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D002614:Chelating Agents; D013849:Thimerosal; D014494:Unithiol; D004113:Succimer; D008628:Mercury