Mercury Toxicity Questions & Answers

Updated: Nov 05, 2018
  • Author: David A Olson, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Questions & Answers

Overview

What is mercury toxicity?

What is the most deadly form of mercury toxicity?

How does mercury enter the food chain?

What is the historical background of mercury toxicity?

What is Minamata disease?

Which industries still use mercury?

What are the complications of mercury toxicity in Minamata disease?

What are the manifestations of severe mercury toxicity?

What are the signs and symptoms of mercury toxicity in infants?

What are the neurological sequelae of mercury toxicity?

What are the long-term effects of mercury toxicity in children?

Who has published a summary of the global impact of mercury toxicity?

What is the pathophysiology of mercury toxicity?

What is the pathophysiology of elemental mercury toxicity?

What are the CNS effects of elemental mercury toxicity?

How does inorganic mercury cause mercury toxicity?

What causes the CNS effects of inorganic mercury toxicity?

How does organic mercury cause mercury toxicity?

What are the CNS effects of methylmercury toxicity?

How is alkyl mercury excreted in mercury toxicity?

How does mercury toxicity damage the nervous system?

What causes apoptosis in the pathophysiology of mercury toxicity?

What is the role of brain edema in the pathophysiology of mercury toxicity?

What is the role of selenium in the pathophysiology of mercury toxicity?

How do genetics affect the pathophysiology of mercury toxicity?

What are the renal effects of mercury toxicity?

What are the sources of elemental mercury toxicity?

What is the primary source of organic mercury exposure in the US?

What are the causes of organic mercury toxicity?

What are the causes of inorganic mercury toxicity?

What is the risk of mercury toxicity from fluorescent light bulbs?

Which plants contain detectable levels of mercury?

How do batteries cause mercury toxicity?

Which workers have the highest risk for occupational exposure leading to mercury toxicity?

Which type of cosmetic has been identified as the source of mercury toxicity?

Which religious and healing practices increase the risk for mercury toxicity?

What is the role of dental amalgam in the etiology of mercury toxicity?

What are the possible outcomes of intentional self-poisoning with oral or injected inorganic mercury?

What is the role of thimerosal in the etiology of mercury toxicity?

What is the incidence of mercury toxicity in the US?

What is the global incidence of mercury toxicity?

Which age groups are most severely affected by mercury toxicity?

What is the prognosis of mercury toxicity?

What are the neuropathic sequelae of mercury toxicity?

What are the possible outcomes of mercury toxicity?

Which form of mercury is most toxic to the fetus?

When is inpatient treatment for mercury toxicity indicated?

What are the long-term effects of mercury toxicity in survivors of Minamata disease?

What is the prognosis of babies exposed to Minamata disease?

What were the outcomes of the original individuals from Minamata Bay who were affected by mercury toxicity?

What is the primary source of environmental exposure to mercury?

What data was used to compile the EPA guideline on mercury exposure from fish consumption?

What are the FDA recommendations for reducing mercury exposure?

What are the acute signs and symptoms of inhaled exposure to elemental mercury?

What is the prognosis of mercury toxicity from inhaled exposure?

What is the risk of mercury toxicity from thimerosal?

What is the role of mercury toxicity in the etiology of autism?

How is mercury toxicity prevented?

What patient information about mercury exposure may prevent mercury toxicity?

What information about common household items should patients receive to reduce accidental mercury exposures?

What should be included in patient education about Minamata disease?

What is the role of fungicide in the etiology of mercury toxicity?

Presentation

What is the diagnostic approach for suspected mercury toxicity?

What are the symptoms of mercury intoxication?

What are the unique features of mercury poisoning?

What are the signs and symptoms of chronic mercury exposure?

How does exposure to inorganic mercury or mercuric salt occur and what is the acute presentation of mercury toxicity?

What are the systemic signs and symptoms of inorganic mercury exposure?

How does organic mercury poisoning occur?

What are the symptoms of organic mercury toxicity?

What sites in the brain does organic mercury toxicity target?

What should be the focus of history in suspected methylmercury toxicity?

What are the classic symptoms of mercury toxicity?

What are the CNS effects of mercury toxicity?

Which physical findings are pathognomonic for mercury toxicity?

Which physical exams should be performed in the evaluation of mercury toxicity?

What are sensory symptoms of mercury toxicity?

What is the incidence of cranial neuropathies in mercury toxicity?

Which findings on neuropsychological testing are characteristic of mercury toxicity?

What are the signs and symptoms of low-level organic mercury exposure?

What are the nonneurologic findings characteristic of mercury toxicity?

DDX

How can mercury toxicity be misdiagnosed?

What are indications for mercury exposure testing?

When should mercury toxicity be considered in a differential diagnosis?

Which conditions should be included in the differential diagnosis of mercury toxicity?

Which conditions should be included in the differential diagnosis of inorganic mercury toxicity?

Which conditions should be included in the differential diagnosis of organic mercury toxicity in neonates?

What are the differential diagnoses for Mercury Toxicity?

Workup

How is mercury toxicity diagnosed?

How are signs, symptoms, and electrophysiologic studies of mercury exposure correlated?

What are the blood mercury levels indicative of mercury toxicity?

What is the role of complete blood count (CBC) in the workup of mercury toxicity?

What is the role of mercury quantification in the workup of mercury toxicity?

What is the role of histology in the workup of mercury toxicity?

What are the comparison levels of mercury analysis in the workup of mercury toxicity?

What is the role of hair analysis in the workup of mercury toxicity?

How is methylmercury detected in the workup of mercury toxicity?

What is the blood level correlation with chronic methylmercury toxicity?

What is the blood-to-plasma ratio following high exposure to inorganic mercury salts?

What is the accuracy of inorganic mercury levels in the workup of mercury toxicity?

What is the role of urine mercury measurement in the workup of mercury toxicity?

What is the correlation between urinary mercury levels and the onset of symptoms in mercury toxicity?

What is the role of short-chained alkyl mercury compounds in the workup of mercury toxicity?

What are the recommendation of the American College of Medical Toxicology (ACMT) for routine postchallenge urinary metal testing for mercury toxicity?

What is the role of toenail mercury measurement in the workup of mercury toxicity?

What is the role of cerebrospinal fluid (CSF) measurement in the workup of mercury toxicity?

What is the role of radiographs in the workup of mercury toxicity?

What is the role of MRI in the workup of mercury toxicity?

What are features of mercury toxicity on MRI?

What is the role of single-photon emission computed tomography (SPECT) in the workup of mercury toxicity?

What is the role of electrophysiologic studies in the workup of mercury toxicity?

Treatment

Why should state and local health officials be notified of mercury toxicity?

What is included in the treatment of mercury toxicity?

When should treatment of acute mercury toxicity be initiated?

How is tremulousness treated in mercury toxicity?

What are the treatment goals for mercury toxicity in Minamata disease?

What is included in prehospital care of acute mercury toxicity?

What is the role of surgery in the treatment of mercury toxicity?

What is included in inpatient care of mercury toxicity?

When should patients with mercury toxicity be transferred to a tertiary care facility?

Which activity modifications are needed in the treatment of mercury toxicity?

Which specialist consultations are needed for the treatment of mercury toxicity?

What are the follow-up care considerations for patients with mercury toxicity?

What is included in the initial supportive care of mercury toxicity?

What is the role of gastric lavage in the treatment of mercury toxicity?

What is the role of activated charcoal in the treatment of mercury toxicity?

What is the role of whole bowel irrigation in the treatment of mercury toxicity?

What is the role of chelating agents in the treatment of mercury toxicity?

What is the role of hemodialysis in the treatment of mercury toxicity?

What is the role of neostigmine in the treatment of mercury toxicity?

When are chelating agents administered in the treatment of mercury toxicity?

Which chelating agents are used in the treatment of mercury toxicity?

What is the role of polythiol in the treatment of mercury toxicity?

What is the role of exchange transfusion in the treatment of mercury toxicity?

What is the efficacy of chelating agents in the treatment of mercury toxicity?

Which dietary modifications are used in the treatment of mercury toxicity?

Which dietary restrictions for pregnant women prevent mercury toxicity?

How is workplace mercury toxicity prevented?

How can pregnant women prevent mercury toxicity?

How is Minamata disease prevented?

How is inhaled mercury toxicity prevented?

What leads to environmental contamination of mercury?

Medications

Which medications are used in the treatment of mercury toxicity?

Which medications in the drug class Gastrointestinal Decontaminants are used in the treatment of Mercury Toxicity?

Which medications in the drug class Chelating Agents are used in the treatment of Mercury Toxicity?