Reply to correspondence letter “Mercury in pediatric poisoning” by G. Guzzi

Abstract

Dear Editor, I wish to thank Dr. Guzzi and colleagues for their valuable comments on our paper [1]. Both inorganic (Hg+2) and organic (methylmercury) mercurials cause rapid hemolysis [2]. In a study performed by Mojzis and Nicak, it was shown that hemolysis progressively declined in relation to the increased concentrations of Hg+2 [3]. We suspected inorganic mercury poisoning because our patient's blood mercury level was very high (5,380 μg/L), and the disappearance of hemolysis was rapid. Moreover, the clinical features suggested acute inorganic mercury intoxication. Unfortunately, the technical equipment for the assessment of mercury red blood cell/plasma distribution that provides more accurate evidence to distinguish the inorganic mercury from the organic one is not available in our hospital. Although DMPS is more specific for the treatment of inorganic mercury intoxication, we used DMSA because DMPS is not commercially available in our country, and our patient's G6PD test was normal.