Elemental mercury poisoning presenting as hypertension in a young child.

Mercury intoxication is an uncommon cause of hypertension in children and can mimic several other diseases, such as pheochromocytoma and vasculitis. Mercury intoxication can present as a diagnostic challenge because levels of catecholamines may be elevated, suggesting that the etiology is a catecholamine-secreting tumor. Once acrodynia is identified as a primary symptom, a 24-hour urine mercury level can confirm the diagnosis. Inclusion of mercury intoxication in the differential diagnosis early on can help avoid unnecessary and invasive diagnostic tests and therapeutic interventions. We discuss a case of mercury intoxication in a 3-year-old girl presenting with hypertension and acrodynia, without a known history of exposure. Chelation therapy successfully treated our patient's mercury intoxication. However, it was also necessary to concurrently treat her hypertension and the pain associated with her acrodynia. Because there were no known risk factors for mercury poisoning in this case, and because ritual use of mercury is common in much of the United States, we recommend high clinical suspicion and subsequent testing in all cases of acrodynia.

Intoxicación por mercurio / Mercury poisoning

Se presenta el caso de un adolescente intoxicado por mercurio por intento autodestructivo. Se analizan las diversas formas de intoxicación por este metal así como su sintomatología, haciendo énfasis en la terapéutica utilizada y al mismo tiempo se mencionan las causas que pueden motivar esta autodestrucción.

Polineuropatia carencial associada à sindrome de Korsakoff / Deficiency polyneuropathy associated with Korsakoff's syndrome

Um caso raro de polineuropatia carencial concomitante com a Síndrome de Korsakoff é apresentado. Säo discutidos os aspectos clínicos, laboratoriais, além do sucesso terapêutico

[Effectiveness of plasma exchange therapy in patients with rheumatoid arthritis and systemic manifestations]. / Zur Wirksamkeit der Plasmaaustauschtherapie bei Patienten mit Rheumatoid-Arthritis und systemischer Manifestation.

For the advantage of the therapeutic plasma exchange in the active rheumatoid arthritis there exist at present contradictory opinions. Three patients with rheumatoid arthritis and systemic manifestation as well as high activity of the disease, in whom the conventional therapy with antirheumatic drugs showed only little effectiveness and which was stopped due to severe side effects, respectively, underwent 6 plasma exchange treatments within 14 days. The subjective condition as well as standardized clinical and laboratory-chemical activity parameters quickly ameliorated. A positive therapeutic effect was to be proved still after 6 to 12 months. In 2 patients a proposed synovectomy could be renounced. The reasonable indication for the plasma exchange will be given when there is an acute immunological reaction which can be shortened by a rapid reduction of pathogenic protein fractions before irreversible morphological injuries occur.