수은 증기 흡입에 의한 급성 폐손상 및 급성 전신성 발진성 농포증 1예
A Case of Acute Lung Injury and Acute Generalized Exanthematous Pustulosis Induced by Inhalation of Mercury Vapor
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Inhalation of mercury vapor is very rare, but if it occurs, fatal damage, such as acute lung injury or death,may ensure. In addition, acute generalized exanthematous pustulosis due to mercury hypersensitivity has rarely been reported in the literature. We experienced a 49-year-old male patient who had been exposed to mercury vapor following burning of mercury-containing materials. Case History: The patient complained of dyspnea, fever,and systemic erythema. Physical examination revealed that he had macular erythema with tiny pustules. His body temperature was 38.3oC and a complete blood count revealed elevated leucocytes. Chest radiographs revealed diffuse airspace opacification in both lungs. Results: He was admitted to the intensive care unit and treated with oxygen, intravenous methylprednisolone 125mg per day, and oral antihistamines. His symptoms improved and his skin lesions resolved completely with desquamation 5 days. On the eighth hospital day, intravenous methylprednisolve was tapered to 62.5 mg methyprednisolone,followed by oral methyprednisolone. He was discharged from the hospital on the 20th hospital day and is currently being followed-up with no aggravation of symptoms or relapse. Conclusion: We report a case of acute lung injury and acute generalized exanthematous pustulosis induced by inhalation of mercury vapor that was successfully treated with early avoidance and steroid therapy.
Abstract
Background: Inhalation of mercury vapor is very rare, but if it occurs, fatal damage, such as acute lung injury or death,may ensure. In addition, acute generalized exanthematous pustulosis due to mercury hypersensitivity has rarely been reported in the literature. We experienced a 49-year-old male patient who had been exposed to mercury vapor following burning of mercury-containing materials. Case History: The patient complained of dyspnea, fever,and systemic erythema. Physical examination revealed that he had macular erythema with tiny pustules. His body temperature was 38.3oC and a complete blood count revealed elevated leucocytes. Chest radiographs revealed diffuse airspace opacification in both lungs. Results: He was admitted to the intensive care unit and treated with oxygen, intravenous methylprednisolone 125mg per day, and oral antihistamines. His symptoms improved and his skin lesions resolved completely with desquamation 5 days. On the eighth hospital day, intravenous methylprednisolve was tapered to 62.5 mg methyprednisolone,followed by oral methyprednisolone. He was discharged from the hospital on the 20th hospital day and is currently being followed-up with no aggravation of symptoms or relapse. Conclusion: We report a case of acute lung injury and acute generalized exanthematous pustulosis induced by inhalation of mercury vapor that was successfully treated with early avoidance and steroid therapy.
참고문헌 (20)
- Rowens B, "Respiratory failure and death following acute inhalation of mercury vapor. A clinical and histologic perspective", Chest, 99, pp.185~190 (1991)
- Aguado S, "Acute mercury vapour intoxication: report of six cases", Nephrol Dial Transplant, 4, pp.133~136 (1989)
- Lim HE, "Mercury inhalation poisoning and acute lung injury", Korean J Intern Med, 13, pp.127~130 (1998)
- 이홍열, "부적을 태운 후 발생한 급성 수은증기 중독에 의한 독성-증례 보고-", 대한중환자의학회지, 25(3), pp.182~185 (2010), 대한중환자의학회
- Matthes FT, "Acute poisoning associated with inhalation of mercury vapor; report of four cases", Pediatrics, 22, pp.675~688 (1958)
- Takahata N, "Accumulation of mercury in the brains of two autopsy cases with chronic inorganic mercury poisoning", Folia Psychiatr Neurol Jpn, 24, pp.59~69 (1970)
- Sidoroff A, "Acute generalized exanthematous pustulosis (AGEP)--a clinical reaction pattern", J Cutan Pathol, 28, pp.113~119 (2001)
- Jung RC, "Death following inhalation of mercury vapor at home", West J Med, 132, pp.539~543 (1980)
- Lien DC, "Accidental inhalation of mercury vapour : respiratory and toxicologic consequences", Can Med Assoc J, 129, pp.591~595 (1983)
- Kanluen S, "A clinical pathologic study of four adult cases of acute mercury inhalation toxicity", Arch Pathol Lab Med, 115, pp.56~60 (1991)
- Asano S, "Review article: acute inorganic mercury vapor inhalation poisoning", Pathol Int, 50, pp.169~174 (2000)
- Liu J, "Mercury in traditional medicines: is cinnabar toxicologically similar to common mercurials?", Exp Biol Med (Maywood), 233, pp.810~817 (2008)
- Levin M, "Acute mercury poisoning and mercurial pneumonitis from gold ore purification", Chest, 94, pp.554~556 (1988)
- Bains VK, "Mercury sensitisation: review, relevance and a clinical report", Br Dent J, 205, pp.373~378 (2008)
- White IR, "Dental amalgam dermatitis", Br Dent J, 156, pp.259~260 (1984)
- 김태성, "Anti-allergic and anti-inflammatory triterpenes from the herb of Prunella vulgaris", PLANTA MEDICA, 66, pp.358~360
- Bhattacharya B, "Acute mercury vapour poisoning in an infant", Ann Trop Paediatr, 17, pp.57~60 (1997)
- Hallee TJ, "Diffuse lung disease caused by inhalation of mercury vapor", Am Rev Respir Dis, 99, pp.430~436 (1969)
- Seaton A, "Acute mercury pneumonitis", Br J Ind Med, 35, pp.258~261 (1978)
- Ho BS, "Mercury vapor inhalation from Chinese red(Cinnabar)", J Toxicol Clin Toxicol, 41, pp.75~78 (2003)