Mercury poisoning presenting with hypertension: report of two cases

Abstract Background Mercury poisoning can cause damage to multiple organs. Secondary hypertension, which is usually misdiagnosed and mistreated, has been rarely reported in cases of mercury poisoning. Methods We herein present two cases of hypertension as the main manifestation of mercury poisoning. Results Case 1 involved a 42-year-old man with blood pressure of 230/190mmHg and urinary mercury level of 131.54μmol/molCr. The patient had been repeatedly exposed to mercury at his workplace and admitted to our department many times. His hypertension quickly normalized after every chelation treatment. Case 2 involved a 10-year-old girl with hypertension (150/110mmHg), rash, and convulsions. She was found to have elevated blood levels of renin, angiotensin II, and aldosterone as well as an elevated urinary mercury level. Her hypertension recovered soon after chelation treatment. Conclusions Mercury poisoning can cause secondary hypertension as the main clinical manifestation or together with multi-organ damage. Renin–angiotensin system activation may be involved in the occurrence and development of hypertension.