title: Neither DMPS nor DMSA is effective in quantitative elimination of elemental mercury after intentional IV injection.
abstract: 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.
authors.affiliation: Department of Toxicology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. Florian.Eyer@t-online.de
authors.forename: Florian
authors.initials: F
authors.lastname: Eyer
authors.forename: Norbert
authors.initials: N
authors.lastname: Felgenhauer
authors.forename: Rudolf
authors.initials: R
authors.lastname: Pfab
authors.forename: Gustav
authors.initials: G
authors.lastname: Drasch
authors.forename: Thomas
authors.initials: T
authors.lastname: Zilker
mesh_terms: 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*
chemical_list: D002614:Chelating Agents; D014494:Unithiol; D004113:Succimer; D008628:Mercury