Abstract
Case report. A 36-year-old jewelry producer presented with tremor, slurred speech, lethargy, headache, and incoordination. On examination he had a coarse tremor of the outstretched hands and protruded tongue, slurred speech, “Hatter's shakes” handwriting, impaired heel-toe walking and heel-shin coordination, mild dysdiadochokinesis, and constricted visual fields to confrontation. The patient received four 5-day courses of oral 2,3-dimercapto-1-propanesulfonate (30 mg/kg/day), which was associated with substantial objective clinical improvement and the excretion of 99,406 μg mercury. Conclusion. We recommend that the administration of 2,3-dimercapto-1-propanesulfonate should be considered in symptomatic patients who have been exposed to mercury vapor and who have supporting analytical confirmation of the diagnosis.
Acknowledgments
We are grateful to Mr. Michael Polo and Mr. Ivan House for technical assistance.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.