Mercury poisoning in a patient with thrombotic events: A case report

Mercury poisoning is an underdiagnosed condition in our setting. It affects multiple organs and systems, often presenting with variable and nonspecific symptoms that may mimic more common diseases. We report the case of a 42-year-old female patient who presented with multiple arterial and venous thrombotic events, cardiovascular complications, progressive cognitive impairment, and long-standing renal dysfunction. Imaging studies revealed embolic phenomena characterized by hyperdense material suggestive of metallic emboli in the thorax, abdomen, and pelvis, raising suspicion of heavy metal poisoning. Diagnosis was confirmed by a 24-hour urinary mercury concentration of 64.03 µg/L. Chelation therapy with the available agent in our setting was initiated, along with intravenous N-acetylcysteine. Selenium was not administered due to its unavailability. Mercury intoxication poses a diagnostic challenge due to its nonspecific clinical manifestations, which may be attributed to more prevalent pathologies in the region.