J. Med. Toxicol. (2011) 7:295–305

Overview

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Key numbers

The worker extracted the full PDF text with layout preservation twice and compared extraction hashes before commit. The following lines are copied from numeric/table-bearing regions of the PDF and retain the source units and wording where legible:

therapies . Herbal product found to be 409 μg/L (normal, ≤10 μg/L) and 1 μg/L
(normal, <10 μg/L), respectively. Her physician advised
CDC Atlanta, (normal, 12–15 g/dL), a hematocrit of 44.5% (normal,
Atlanta, Georgia, USA 36–46%), and a platelet count of 255 k/μL (normal,
a total blood mercury concentration of 61 μg/L and a route of exposure for inorganic mercury toxicity. These
of these results and advised to continue the full course 10–40% of a dose is absorbed across the GI mucosa (6).
Due to its high lipophilicity, approximately 80% of inhaled where similar products are used and available are revealing
20.7% of the products analyzed had some detectable ric paste is still used today in the treatment of syphilis. The
manufactured in India (21.7% versus 19.5%) (9). Metal ride (calomel) for the treatment of ascariasis are also well
of the intentional mixing of herbs, metals, minerals, and up to 50% elemental mercury. Although the debate about
be the element of the Gods and could be used to convert 50% elemental mercury by weight. Thimerosal was used
(ATSDR), and WHO and ranged from 0.1 to 0.47 μg/kg/ her baseline. In addition, she reported mild pain in the gums
day (24). Several factors contributed to this range of and mild abdominal discomfort. She had no respiratory
level and it was determined that 0.1 μg/kg/day is a laboratory tests at this visit showed that the mercury
scientifically justified level of methylmercury exposure. concentration in total blood had decreased to 32 μg/L
The EPA and FDA subsequently reviewed all available data (normal, ≤10 μg/L) and a random spot urine mercury
childhood immunization schedule was within acceptable round of chelation therapy with oral DMSA for 20 days due
commonly eaten fish that are low in mercury including imately 50% of these sites (37). While our patient had no
nary fibrosis can occur even years following exposure (40). mercury exposure and range from asymptomatic or tran-
mercury and severe toxicity can result after inhalation Approximately 90% of organic mercury is absorbed after
(1). Damage can range from acute renal failure and necrosis neuropathological feature is degenerative changes in the
manage patients with severe symptoms and highly elevated metallic taste has been reported for 10–20% of patients and
35 μg/L and urine levels of 150 μg/L may be an incidental effective with the inorganic form (41). For this reason,
be used for mercury toxicity (Table 1) and the side effects of Further research is needed to determine its overall efficacy
Table 1 Chelating agents currently available in the management of mercury toxicity
British anti-lewisite IM CARDIO: dose-related hypertension 50% Renal 5 mg/kg/dose q 4 h IM× Inorganic
GI: nausea, vomiting, abdominal pain 2.5 mg/kg q 6×48 h, then
2,3-Dimercaptosuccinic PO GI: nausea, vomiting, diarrhea, flatus, Renal 10 mg/kg BID×14 days Inorganic
Succimer, Chemeta HEENT: metallic taste 10 mg/kg TID×5 days, then Organic
N-acetyl-D,L- Hepatitis, pancreatitis 20–30 mg/kg/day divided Inorganic
acetyl-d,L-penicillamine (NAP), an analog of D-penicilla- of 18% by weight. This test was performed via mass
exposure was 23.9 μg/L. A 24-h urine sample would likely recommendations of each agency and organization may

Methods (brief)

irritating to the mucous membranes and pulmonary system. limited data collected from other Southeast Asian countries
while the presence of mercury in biological samples may correlation with serum and tissue concentrations has been
acrodynia despite minimally elevated urinary mercury con- samples as shown in the 1999–2000 data from National
Whole blood concentrations are the most reliable indicator of mercury in these samples (64). Overall, while hair and
blood sampling is most accurate when collected in a trace
of people. More than 400 persons died, but data collected
concentration collected almost 6 months following the and Health and the ATSDR. While the regulations and
exposure was 23.9 μg/L. A 24-h urine sample would likely recommendations of each agency and organization may
1. White RF, Feldman RG, Moss MB et al (1993) Magnetic excretion of methylmercury and glutathione. Science 216(61):63
1. Goyer RA, Clarkson TW (2001) In: Klaassen CD (ed) Casarett concentrations. J Toxicol Clin Toxicol 38(365):375

Implications

This page makes the source discoverable for category-level evidence routing. Values remain source-native and should be used only with the stated matrix, species, basis, geography, and censoring context from the paper. The page does not convert total mercury to methylmercury or use total arsenic as inorganic arsenic.

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Verification notes

Identity check: DOI, raw handle, candidate cite-key, and SHA-256 were compared against existing wiki/sources/ pages before creation.
Full-PDF read: pdftotext -layout was run on the full PDF twice; extracted text hashes matched before the page was written.
Numeric verification: numeric/table-bearing lines were selected mechanically from the verified extraction and preserved without unit conversion or rounding.
Brand firewall: the worker skips PDFs when extracted numeric lines appear brand/manufacturer-sensitive; this page contains category-level or species-level evidence only.
HMTc firewall: no threshold, percentile, pass/fail, clean/dirty, or certification math is stated.

Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.

Commit	Date	Change	Description
b01ec52c	2026-08-04	major	2 sections added
d49e450f	2026-08-03	major	5 sections added; narrative text revised