Acute renal failure following exposure to metallic mercury

Mercury exists in three forms: elemental, inorganic, and organic. Each form produces a unique profile of toxicity. Acute poisoning with inorganic salts is well-known, but few reports are available regarding oral elemental (metallic) mercury intoxication. Ingestion of metallic mercury is usually of no concern because of poor gastrointestinal absorption. We report a very rare case of acute renal failure (ARF) following ingestion of metallic mercury. A 67-year old man swallowed an unknown quantity of metallic mercury in a suicide attempt. He developed severe pneumonitis and ARF with anuria. The whole blood mercury concentration was extremely high (157.7 μg/dl). In this case, inhalation of vaporized mercury might have contributed to the significant systemic absorption, but chelating therapy was not performed because of severe renal failure. Hemodialysis was performed 13 times and discontinued 26 days after mercury ingestion. Consequently, the patient recovered normal renal function.