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LETTER |
Pediatrics Department D, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 15, Beer Sheva 8410, Israel; matyl@bgumail.bgu.ac.il
Correspondence to:
Correspondence to
Dr Lifshitz
Keywords: acrodynia; mercury; poisoning
Acrodynia, a rare disorder, is a form of chronic mercury poisoning.1 We report two siblings who developed the classic clinical picture of acrodynia.
A 4
12 year old boy was admitted with dysuria, general weakness, and loss of appetite. He had hypertension (140/95 mm Hg) and tachycardia (141 beats/min). He was irritable and depressed, and had a diffuse itching papular rash with palmar erythema and superficial desquamation (fig 1
). Initial evaluation revealed a normal complete blood count and a normal blood chemistry. Urine analysis and complement levels were normal. Vanillymandelic acid in a 24 hour urine collection was 22.2 µmol/day. Duplex scan of the renal arteries, abdominal ultrasound, and computerised tomography (CT) of the chest and abdomen, were all normal. Heart echocardiography showed mild hypertrophy of the myocardium. TSH was 5.53 mU/l, and free thyroxine 24.45 pmol/l. A brain CT scan revealed a point calcification at the right caudate
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