title: Inorganic mercury intoxication: A case report.
abstract: Mercury is a heavy metal with unique physico-chemical properties, and it is well distributed throughout the environment, being present in soil, water and air. This non-essential element is considered by the World Health Organization (WHO) as one of the ten most troublesome chemical to public health. Its toxicity spectrum depends on the chemical form in which it presents: elemental (metallic), organic or inorganic. The known intoxications are mainly occupational (mining, agriculture, incineration) or related to the use of dental amalgams or the consumption of contaminated fish and shellfish. Nowadays, acute exposures to toxic amounts of mercury are increasingly rare, especially those involving inorganic mercury compounds. The rate is even lower if we refer to intentional poisonings. Although there is a growing understanding of the toxicokinetics of mercury, there is still a lack of studies that support the emerging theories about its bioavailability in humans. In this manuscript we describe a rare case of an individual who committed suicide by ingesting mercuric oxide. The aim is to offer a medical contribution to the better understanding of the kinetics of this metal, making a discussion based on published literature and analyzing its distribution, metabolism, internal doses, target and reservoir organs. The whole case - clinical course of the victim and her fatal destiny, the ante- and post-mortem sample concentrations and the necropsy findings - illustrates a situation that meets specific features of acute poisoning by ingestion of inorganic mercury, thus constituting an important support towards a more realistic and a based on evidence understanding of mercury biodistribution in humans.
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal. Electronic address: danielm.days@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dias
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Bessa
authors.affiliation: Faculty of Medicine, University of Porto, Porto, Portugal; Anatomical Pathology Service, Centro Hospitalar São João, Porto, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Guimarães
authors.affiliation: UCIBIO/REQUIMTE - Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Portugal.
authors.forename: Maria Elisa
authors.initials: ME
authors.lastname: Soares
authors.affiliation: UCIBIO/REQUIMTE - Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Portugal.
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Bastos
authors.affiliation: National Institute of Legal Medicine and Forensic Sciences, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
authors.forename: Helena M
authors.initials: HM
authors.lastname: Teixeira
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017669:Mercury Compounds / Q000506:poisoning*; D008630:Mercury Poisoning / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D051437:Renal Insufficiency / Q000139:chemically induced*; D012128:Respiratory Distress Syndrome / Q000139:chemically induced*; D013405:Suicide
chemical_list: D017669:Mercury Compounds
keywords: Inorganic Mercury; Intoxication; Mercuric oxide; kinetics