Neither DMPS nor DMSA is effective in quantitative elimination of elemental mercury after intentional IV injection.
BACKGROUND
Intravenous injection of elemental mercury (Hg) is rare and considered relatively harmless. Treatment recommendations vary and the effectiveness of chelation therapy is controversial.


METHODS
A 27-year-old man intravenously injected 1.5 mL of elemental Hg. Within 12 hours he became febrile, tachycardic and dyspneic. Physical examination was unremarkable. X-rays showed scattered radiodense deposits in the lung, heart, intestinal wall, liver and kidney. The serum Hg level on admission was 172 microg/L and peaked on day 6 at 274 microg/L. Cumulative renal elimination during a five day oral treatment period with 2,3-dimercaptopropane-1-sulfonate (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) was 8 mg and 3 mg, respectively.


CONCLUSIONS
Although urinary excretion could be enhanced during chelation therapy, Hg deposits in organs resulted in negligible elimination of mercury compared to the exposed dose.
Eyer
Florian
F
Department of Toxicology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. Florian.Eyer@t-online.de
Felgenhauer
Norbert
N
Pfab
Rudolf
R
Drasch
Gustav
G
Zilker
Thomas
T
D000328:Adult; D002614:Chelating Agents / Q000627:therapeutic use*; D003106:Colon / Q000000981:diagnostic imaging / Q000378:metabolism; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008628:Mercury / Q000493:pharmacokinetics; D008630:Mercury Poisoning / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D011859:Radiography; D004113:Succimer / Q000627:therapeutic use*; D013406:Suicide, Attempted; D014494:Unithiol / Q000627:therapeutic use*
D002614:Chelating Agents; D014494:Unithiol; D004113:Succimer; D008628:Mercury