Infantile mercury poisoning

Infantile mercury poisoning, also known as acrodynia or pink disease, is a toxic condition resulting from mercury exposure in infants and young children. It is not a genetic disorder but rather an acquired poisoning caused by exposure to mercury in various forms, including elemental mercury, inorganic mercury salts, or organic mercury compounds. Sources of exposure in infants may include contaminated breast milk, teething powders (historically), broken thermometers, traditional remedies, or environmental contamination. Mercury is a potent neurotoxin that affects multiple organ systems, particularly the nervous system, kidneys, skin, and gastrointestinal tract. Key clinical features in infants include irritability, excessive crying, photophobia (light sensitivity), pink discoloration of the hands and feet (acral erythema), skin peeling, excessive sweating (diaphoresis), tachycardia, hypertension, hypotonia, feeding difficulties, and failure to thrive. Neurological manifestations may include developmental regression, tremor, insomnia, and peripheral neuropathy. Renal involvement can manifest as nephrotic syndrome or renal tubular dysfunction. The skin findings, particularly the characteristic pink, swollen, and painful extremities, historically gave rise to the name "pink disease." Diagnosis is based on clinical suspicion, history of mercury exposure, and confirmation through elevated mercury levels in blood and urine. Treatment involves immediate removal of the mercury source and chelation therapy, typically with agents such as dimercaprol (BAL), succimer (DMSA), or unithiol (DMPS), depending on the form of mercury and severity of poisoning. Supportive care including nutritional support, management of pain and irritability, and monitoring of renal and neurological function is essential. Early recognition and treatment are critical, as delayed intervention can lead to permanent neurological damage. Long-term neurodevelopmental follow-up is recommended for affected children.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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