DMPS can reverse the features of severe mercury vapor-induced neurological damage.
METHODS
A 36-year-old jewelry producer presented with tremor, slurred speech, lethargy, headache, and incoordination. On examination he had a coarse tremor of the outstretched hands and protruded tongue, slurred speech, "Hatter's shakes" handwriting, impaired heel-toe walking and heel-shin coordination, mild dysdiadochokinesis, and constricted visual fields to confrontation. The patient received four 5-day courses of oral 2,3-dimercapto-1-propanesulfonate (30 mg/kg/day), which was associated with substantial objective clinical improvement and the excretion of 99,406 microg mercury.


CONCLUSIONS
We recommend that the administration of 2,3-dimercapto-1-propanesulfonate should be considered in symptomatic patients who have been exposed to mercury vapor and who have supporting analytical confirmation of the diagnosis.
West Midlands Poisons Unit, City Hospital, Birmingham, B18 7QH, UK.
Sally M
SM
Bradberry
Timothy M T
TM
Sheehan
Christopher R
CR
Barraclough
J Allister
JA
Vale
D000284:Administration, Oral; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D055498:Jewelry; D008297:Male; D008630:Mercury Poisoning / Q000188:drug therapy* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014494:Unithiol / Q000627:therapeutic use*
D000931:Antidotes; D002614:Chelating Agents; D014494:Unithiol