Organ mercury levels in infants with omphaloceles treated with organic mercurial antiseptic

Abstract

The introduction of the application of 0.1% tincture of Thimerosal (thiomersal) in the treatment of exomphalos is generally attributed to Grob (1957). No unequivocal cases of organic mercury poisoning have been reported after its use in patients with exomphalos though several cases of 'pink disease have been reported, as well as a case of 'mercury intoxication'. This is thought to be an idiosyncratic reaction unrelated to excessive dosage and should be distinguished from true poisoning. Analysis of fresh tissue samples obtained at necropsy from an infant with exomphalos treated by thiomersal application who died unexpectedly showed raised tissue levels of mercury. This prompted the authors to search the records at the Hospital for Sick Children, Toronto, for other mercury-treated cases of exomphalos and carry out organ mercury analysis. Samples of fresh and fixed tissues from infants with exomphalos treated by thiomersal application were analysed for mercury content. The results showed thiomersal can induce blood and organ levels of organic mercury which are well in excess of the minimum toxic level in adults and fetuses. The analysis of fresh and fixed tissues must be carefully controlled against normal tissues in order to interpret mercury levels accurately.