[Repeated metallic mercury intravenous injections for doping]

Area of Science:

• Toxicology
• Nephrology
• Environmental Health

Background:

• A 24-year-old patient presented with nephropathy of unknown origin and a history of suicide attempts.
• The patient had a history of intentional overdose involving tricyclic antidepressant drugs (TLPD) and ethanol.

Observation:

• Toxicological analysis revealed elevated serum TLPD (548 µg/L) and ethanol (2.1 g/L).
• Chest X-ray identified disseminated metallic particles in the lungs, suggestive of metallic mercury.
• The patient admitted to intravenous metallic mercury injections over three years to enhance physical performance.

Findings:

• Serum mercury levels were significantly elevated at 300 µg/L.
• Urinary mercury excretion was high at 500 µg/L/24 hours.
• The patient's condition involved co-existing TLPD/ethanol toxicity and chronic metallic mercury exposure.

Implications:

• This case highlights a novel route of heavy metal exposure through self-injection for perceived performance enhancement.
• Chronic mercury exposure can lead to severe health consequences, including nephropathy and potential neurological damage.
• This case underscores the importance of comprehensive toxicological screening in patients with unexplained medical conditions and a history of substance abuse.