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.
Bradberry
Sally M
SM
West Midlands Poisons Unit, City Hospital, Birmingham, B18 7QH, UK.
Sheehan
Timothy M T
TM
Barraclough
Christopher R
CR
Vale
J Allister
JA
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