What are the symptoms of acrodynia ? and how to treat them ?

 ACRODYNIA :

Acrodynia is a medical condition which occurs due to mercury  poisoning . The condition of pain and dusky pink discoloration in the hands and feet is due to exposure  or ingesting of mercury . It was known  as pink disease before it was accepted that it was just mercury  poisoning . The  word  acrodynia  is derived from the Greek which means pain. It might be used to indicated  that a  patient has pain  in  the hands or feet . the condition is known by various  other  names  including  hydrargyria , mercurialism , erythredema polyneuropathy , swift's and swift  feer disease .



 SIGN & SYMPTOMS :

Besides and discoloration , swelling and desquamation may occur . Since mercury blocks  the degradation  pathway  of catecholacholamines , epinephrine excess causes  profuse  sweating  , tachycardia , salivation  and elevated  blood  pressure . Mercury is suggest to infunction activate which is necessary for catecholamine  catabolism by  may show  red cheeks and nose , red lips , loss of hair , teeth , and nails ,transient rashes , hypotonia  and photophobia . Other  symptoms  may include  kidney dysfunction  or neuropsychiatric  symptoms . There is some evidence  that the same mercury poisoning may predispose to young's syndrome . 

WHAT ARE THE CAUSES OF ACRODYNIA ?

Mercury  compounds like calomel were historically used for various medical purposes : as laxalives , diuretics , antiseptics or antimicrobial drugs for syphilis , typhus and yellow fever . Teething powders were a widespreads source of mercury  poisoning  until the recognition of mercury  toxicity in the 1940s . however  , mercury  poisoning and acrodynia still exist today . Modern sources of mercury intoxication include broke  thermometers . 



HOW TO TREAT ACRODYNIA  AND  DIAGNOSIS ?

Removal of the inciting agent is the goal of treatment . Correcting fluid and electrolyte losses and rectifying any nutritional imbalances are of utmost important in the treatment of the disease . The chelating agent meso2,3- dimercaptosuccinic acid  has been  shown to be  the preferred treatment modality . it can almost completely prevent  methylmercury  uptake by erthrocytes and hepatocytes . It has a less favourable adverse effect  profile  than meso 2, 3- dimercaptosuccinic acid. Hemodialysis with and without the addition of L- cysteine as a chelating agent has been used in some patients  experiencing  acute kidney injury from mercury toxicity . Tolazoline has been  shown to offer symptomatic relief from sympathetic overactivity . this can easily progress to bacterial secondary  infection  with a tendency for ulcerating pyoderma . 



The standard  of care is discontinuation of the environmental exposure and chelation therapy done safely with the Andrew Cutler Protocol , DMPS / DMSA and ALA taken orally in small doses according to their half - lives  over a 72 hours  period , followed by a 3 day break . 

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