| Stevens-Johnson syndrome in a child with chronic mercury exposure and 2,3-dimercaptopropane-1-sulfonate (DMPS) therapy. | |
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MedLine Citation:
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PMID: 18568806 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Stevens-Johnson syndrome (SJS) is an uncommon and potentially serious mucocutaneous disease. The most important step in the management of SJS is early recognition and immediate withdrawal of the causative agent. We present a patient with SJS associated with dimercaptopropane-1-sulfonate (DMPS) therapy. CASE REPORT: An asymptomatic 11-year old boy who had been exposed chronically to mercury vapour had a 24-hour urine mercury concentration of 37 microgram/L (reference value <10 microgram/L). Exposure to the mercury vapour was stopped and treatment with oral DMPS was begun. After two weeks of therapy, he developed a disseminated cutaneous eruption of red pruritic macules on his chest and back, which three days later had spread all over his body with the discrete maculae becoming confluent; erosions and crusts developed on his lips and he had blisters in his mouth. The diagnosis of SJS was made, the DMPS was stopped, and the SJS resolved gradually. DISCUSSION: Chelation agents like DMPS or DMSA are increasingly used and are available over the counter in some countries. These drugs are used in patients with complaints that are attributed to mercury-containing dental amalgams and in children with autism. CONCLUSION: The reported association suggests that SJS may be a potential complication of DMPS therapy, and this should be considered in the risk-benefit analysis of chelation. The reported association suggests that SJS may be a potential complication of DMPS therapy, and this should be considered in the risk-benefit analysis of chelation. |
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Authors:
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A A A Van der Linde; S Pillen; G P J M Gerrits; J N Bouwes Bavinck |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Clinical toxicology (Philadelphia, Pa.) Volume: 46 ISSN: 1556-9519 ISO Abbreviation: Clin Toxicol (Phila) Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-23 Completed Date: 2008-07-17 Revised Date: 2009-11-17 |
Medline Journal Info:
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Nlm Unique ID: 101241654 Medline TA: Clin Toxicol (Phila) Country: United States |
Other Details:
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Languages: eng Pagination: 479-81 Citation Subset: AIM; IM |
Affiliation:
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Canisius Wilhelmina Hospital, Pediatrics, Nijmegen, Netherlands. annelieke@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antidotes
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therapeutic use* Chelating Agents / therapeutic use* Child Environmental Exposure / adverse effects Humans Male Mercury Compounds / poisoning Mercury Poisoning* Stevens-Johnson Syndrome / chemically induced* Unithiol / therapeutic use* Volatilization |
| Chemical | |
Reg. No./Substance:
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0/Antidotes; 0/Chelating Agents; 0/Mercury Compounds; 4076-02-2/Unithiol |
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