Pune Girl's Mercury Poisoning from Herbal Powder Leads to Severe Brain Condition
In a concerning medical case from Pune, doctors have discovered that a herbal powder used to treat a facial white patch contained dangerously high levels of mercury. This contamination triggered severe hypertension and a rare brain condition in a nine-year-old girl, highlighting significant risks associated with unsupervised medication use.
Hospital Investigation and Diagnosis
Specialists at Sahyadri Manipal Hospital on Nagar Road conducted a thorough investigation after the child was admitted in a comatose state. Routine tests failed to explain her symptoms, which included altered consciousness, continuous refractory convulsions, severe headaches, visual disturbances, and sluggishly reacting pupils. Her blood pressure was alarmingly high, measuring around 200 systolic and 120 diastolic, levels typically considered severe even in adults.
An MRI scan confirmed the presence of Posterior Reversible Encephalopathy Syndrome (PRES), a condition characterized by brain swelling often linked to acute hypertension. Despite emergency management and multiple medications, her blood pressure remained persistently elevated, prompting doctors to search for underlying causes.
Laboratory Analysis Reveals Mercury Contamination
After evaluating renal, cardiac, and endocrine factors, including rare conditions like pheochromocytoma, all tests returned normal results, creating a diagnostic dilemma. A detailed family history then revealed that the girl had been given a herbal powder for nearly three weeks to reduce a white patch on her face. The powder was sent to a laboratory for analysis.
Senior paediatric intensivist Dr. Sagar Lad reported, "Laboratory analysis of the herbal powder showed extremely high mercury content — over 1,100mg per 100g — indicating heavy contamination. Urine testing of the child revealed mercury levels of over 300 µg/L, far exceeding the normal reference range of 0.14–4.2 µg/L." Mercury is excreted through urine, making it a key diagnostic marker for exposure. The National Poisons Information Centre (NPIC) at AIIMS New Delhi assisted in confirming mercury poisoning as the primary cause.
Rarity and Risks of Mercury Toxicity
Dr. Lad emphasized that mercury poisoning is a rare condition in children, with lead poisoning being more common. However, mercury toxicity can lead to severe neurological symptoms, joint and muscle pain, and refractory hypertension through autonomic dysfunction. "The herbal medicine was analysed and we found significant mercury content in it. The child had been taking it without medical supervision for weeks. Such unsupervised and prolonged use of herbal medications can become life-threatening," he warned.
Treatment and Recovery
Recognizing the cause proved critical for effective treatment. Doctors initiated chelation therapy, starting with injections for three to five days, followed by oral chelation for two weeks, based on guidance from the national toxicology centre. Following this treatment, the child showed marked improvement. Her blood pressure gradually normalized, and all anti-hypertensive drugs were discontinued. Repeat urine tests indicated mercury levels dropping below 10 µg/L.
Senior paediatrician Dr. Prateek Kataria, who treated the child alongside Dr. Lad, stated, "She made a complete neurological recovery and was back to her baseline — healthy, stable, and symptom-free — by the time of discharge." This case underscores the importance of medical supervision when using herbal or alternative medications, especially in pediatric care.
