Mercury Toxicity Mimicking Pheochromocytoma
Aisha Ansar1, Kyle McNerney1, Bess Adkins Marshall1
1Department of Pediatrics, Washington University in St. Louis, St. Louis, MO 63110, USA.
JCEM Case Reports
|August 4, 2025
Summary
Mercury intoxication in children can cause hypertension and mimic pheochromocytoma. Evaluating for mercury exposure is crucial in pediatric hypertension cases presenting with catecholamine excess symptoms.
Area of Science:
- Pediatric Endocrinology
- Environmental Toxicology
Background:
- Hypertension in children can be challenging to diagnose.
- Pheochromocytoma is a rare tumor causing catecholamine excess.
- Mercury intoxication is a potential, often overlooked, cause of pediatric hypertension.
Observation:
- An 8-year-old girl presented with hypertension, tachycardia, night sweats, and myalgias.
- Initial workup for pheochromocytoma was negative, but urinary catecholamines were elevated.
- Ayurvedic supplements were identified as the source of mercury exposure.
Findings:
- Elevated blood and urine mercury levels confirmed mercury intoxication.
- Treatment with oral chelation (succimer) and antihypertensives (doxazosin) led to symptom resolution.
- Mercury toxicity successfully mimicked pheochromocytoma, highlighting diagnostic challenges.
Implications:
- Pediatric hypertension evaluations should include mercury exposure assessment.
- Ayurvedic and other alternative supplements require careful scrutiny for toxic elements.
- Prompt diagnosis and chelation therapy are vital for managing mercury intoxication in children.
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