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Acrodynia

Feers Disease


Presentation

  • Besides peripheral neuropathy (presenting as paresthesia or itching, burning or pain) and discoloration, swelling (edema) and desquamation may occur.[en.wikipedia.org]
  • The presented pathogenetic model may lead to new preventive- and therapeutic strategies for Kawasaki's disease.[ncbi.nlm.nih.gov]
  • In summary, acrodynia, although rare, should be considered in every child presenting with hypertension, tachycardia, mental changes, and cutaneous manifestations.[doi.org]
  • We present a case of acrodynia caused by mercury exposure in a previously healthy 5-year-old girl who developed hypertension, palmoplantar pruritus, and a papulovesicular eruption.[ncbi.nlm.nih.gov]
  • A case of acrodynia in an eight-and-a-half-year-old girl is presented whose symptoms--profuse perspiration, swelling, desquamation, pain, itching of the extremities, pinkish color of the nose and cheeks and hypertension--responded sharply to nifedipine[ncbi.nlm.nih.gov]
Fatigue
  • […] and also on the tip of the nose (due to an allergic reaction of the skin to the chemical) Pain, burning or itching sensation due to peripheral neuropathy Loss of superficial layers of skin - a process called desquamation Weight loss, loss of appetite Fatigue[dovemed.com]
  • Fatigue, pain in the feet, anorexia, and weight loss were found in 50%.[doi.org]
  • MFF, or "brass founder’s ague," "zinc shakes," or "Monday morning fever" as it is variously known, is characterized by fever, headache, fatigue, dyspnea, cough, and a metallic taste occurring within 3-10 hours after exposure.[emedicine.com]
  • Complications include the following (see Presentation): Acute perioral and facial paresthesias Visual-field constriction Respiratory distress and nonspecific dermatitis Extremity numbness eventually appears, along with headache, fatigue, and tremor Ataxia[emedicine.com]
Loss of Appetite
  • Symptoms of acrodynia include irritability, insomnia, loss of appetite, loosening of teeth, inflammation of the mouth, and… Read More[britannica.com]
  • A 4½12 year old boy was admitted with dysuria, general weakness, and loss of appetite. He had hypertension (140/95 mm Hg) and tachycardia (141 beats/min).[doi.org]
  • Manifestations of acridity from the mucous membranes: - Hyper-salivation - Ulcerative stomatitis - Gingivitis In most recorded cases, this disease begins with an increase in overall body temperature, loss of appetite, photophobia, anxiety and anguish.[en.med-directory.com]
  • These include: depression, apathy, fretfulness, loss of appetite, social withdrawal, photophobia sweating, hypotonia, misery, slurring or loss of speech, and insomnia.[worldmercuryproject.org]
Diarrhea
  • Definitions from The Century Dictionary. noun An epidemic disease characterized by disturbances in the alimentary canal (vomiting, colic, diarrhea), by nervous symptoms (especially pain in the extremities), sometimes by cramp or anæsthesia, and by a dermatitis[wordnik.com]
  • The signs and symptoms of Acrodynia comprise loss of skin layers, peripheral neuropathy, vomiting and diarrhea, renal failure, and memory loss and loss of focus.[dovemed.com]
  • An epidemic disease characterized by disturbances in the alimentary canal (vomiting, colic, diarrhea), by nervous symptoms (especially pain in the extremities), sometimes by cramp or anæsthesia, and by a dermatitis affecting the hands and feet.[wordgamedictionary.com]
  • , painful neuropathy, coma, autonomic instability, MODS Late: Alopecia, Mees lines, residual neurologic symptoms Alopecia, neuropathy Toxic: 3 µg/L (blood) MDAC Prussian blue Zinc MFF (oxide fumes); vomiting, diarrhea, abdominal pain (ingestion) Copper[emedicine.com]
Polydipsia
  • […] burning or itching sensation due to peripheral neuropathy Loss of superficial layers of skin - a process called desquamation Weight loss, loss of appetite Fatigue Ulcers on the gums Loss of muscle tone Excess saliva production; being excessively thirsty (polydipsia[dovemed.com]
  • Other presenting complaints or findings in 1 or 2 patients included insomnia, tremor, back pain, headache, palpitations, generalized flushes, polydipsia, pruritis, and opisthotonos. Clinical presentations suggested pheochromocytoma.[doi.org]
Hypersalivation
  • With battery ingestion, one would expect signs of inorganic mercury exposure, such as hypersalivation and vomiting, rather than signs of organic mercury poisoning. One major risk factor for mercury toxicity is industrial contamination.[emedicine.com]
Cutaneous Manifestation
  • Mercury toxicity has systemic manifestations as well as cutaneous manifestations, which can appear similar to those found in a number of other diseases.[ncbi.nlm.nih.gov]
  • The many cutaneous manifestations of this once common disease are discussed.[ncbi.nlm.nih.gov]
  • In summary, acrodynia, although rare, should be considered in every child presenting with hypertension, tachycardia, mental changes, and cutaneous manifestations.[doi.org]
  • PHYSICAL MANIFESTATIONS: The initial symptoms are followed by the numerous cutaneous manifestations in 2 - 4 weeks. The skin changes are characteristic.[drstandley.com]
Alopecia
  • Alopecia (hair loss) has also been noted. Nail loss is also noted. DISCLAIMER: **This web site's goal is to provide you with information that may be useful in attaining optimal health. Nothing in it is meant as a prescription or as medical advice.[drstandley.com]
  • Alopecia and nail loss have also been reported. What is the treatment of acrodynia? The goal of treatment is to remove the mercury and correct any fluid or electrolyte imbalances.[dermnetnz.org]
  • The complications of Acrodynia could include: Weakening of the gums leading to loss of teeth Early hair loss (alopecia) Loss of fingernail and toenail Chronic mercury exposure leads to kidney failure Skin sensitization through chronic skin exposure resulting[dovemed.com]
  • , Mees lines, residual neurologic symptoms Alopecia, neuropathy Toxic: 3 µg/L (blood) MDAC Prussian blue Zinc MFF (oxide fumes); vomiting, diarrhea, abdominal pain (ingestion) Copper deficiency: anemia, neurologic degeneration, osteoporosis Normal range[emedicine.com]
Palmar Erythema
  • Figure 1 Diffuse itching papular rash with palmar erythema and superficial desquamation in a 4½ year old boy. References Ellenhorn MJ, Schonwald S, Ordog G, et al. Metals and related compounds.[doi.org]
  • Figure 1 Diffuse itching papular rash with palmar erythema and superficial desquamation in a 4½ year old boy. References Ellenhorn MJ , Schonwald S, Ordog G, et al . Metals and related compounds.[adc.bmj.com]
Papular Rash
  • Figure 1 Diffuse itching papular rash with palmar erythema and superficial desquamation in a 4½ year old boy. References Ellenhorn MJ, Schonwald S, Ordog G, et al. Metals and related compounds.[doi.org]
  • Figure 1 Diffuse itching papular rash with palmar erythema and superficial desquamation in a 4½ year old boy. References Ellenhorn MJ , Schonwald S, Ordog G, et al . Metals and related compounds.[adc.bmj.com]
Eczema
  • Dermatologic effects range from mild rashes and eczema to total body rash, or acrodynia.[freethesaurus.com]
Photophobia
  • Symptoms include raw-beef hands and feet, superficial sensory loss, photophobia, tachycardia, muscular hypotonia, changes in temperament, stomatitis, periodontitis, and premature loss of teeth.[medical-dictionary.thefreedictionary.com]
  • A syndrome caused almost exclusively in the past by mercury poisoning : in children, characterized by erythema of the extremities, chest, and nose, gastrointestinal symptoms and by polyneuritis (in Japan); in adults, characterized by anorexia, photophobia[medicine.academic.ru]
  • A syndrome caused almost exclusively by mercury poisoning in children and gastrointestinal symptoms, in adults, by anorexia, photophobia, sweating, and tachycardia (fast heart beat). 3.[wordinfo.info]
  • The symptoms of irritability, photophobia (sensitivity to light), pink discoloration of the hands and feet, and polyneuritis (inflammation involving 2 or more nerves) can be attributed to chronic exposure to mercury.[drstandley.com]
  • Affected children may show red cheeks and nose, red (erythematous) lips, loss of hair, teeth, and nails, transient rashes, hypotonia and photophobia. Other symptoms may include kidney dysfunction (e.g.[en.wikipedia.org]
Dysuria
  • A 4½12 year old boy was admitted with dysuria, general weakness, and loss of appetite. He had hypertension (140/95 mm Hg) and tachycardia (141 beats/min).[doi.org]
Irritability
  • Symptoms of acrodynia include irritability, insomnia, loss of appetite, loosening of teeth, inflammation of the mouth, and… Read More[britannica.com]
  • Medical attention was sought for a 23-month-old toddler because of anorexia, weight loss, irritability, profuse sweating, peeling and redness of his fingers and toes, and a miliarial rash.[ncbi.nlm.nih.gov]
  • Many times I will cry so much that the very next day my eyes burns with irritation and pain. Is all this normal? I think I am getting bipolar. A. I would suggest going to your doctor and asking to speak to someone.[medical-dictionary.thefreedictionary.com]
  • * ac·ro·dyn·ia .ak-rō-'din-ē-ə n a disease of infants and young children that is an allergic reaction to mercury, is characterized by dusky pink discoloration of hands and feet with local swelling and intense itching, and is accompanied by insomnia, irritability[medicine.academic.ru]
  • Among children, prolonged exposure to inorganic mercury also might cause acrodynia, irritability, anorexia, and poor muscle tone (4).[freethesaurus.com]
Insomnia
  • Symptoms of acrodynia include irritability, insomnia, loss of appetite, loosening of teeth, inflammation of the mouth, and… Read More[britannica.com]
  • ˌak-rō-ˈdin-ē-ə \ Medical Definition of acrodynia : a disease of infants and young children that is an allergic reaction to mercury, is characterized by dusky pink discoloration of hands and feet with local swelling and intense itching, and is accompanied by insomnia[merriam-webster.com]
  • Fanconi syndrome) or neuropsychiatric symptoms (emotional lability, memory impairment, insomnia). Thus, the clinical presentation may resemble pheochromocytoma or Kawasaki disease.[en.wikipedia.org]
  • […] pain ] * * * ac·ro·dyn·ia .ak-rō-'din-ē-ə n a disease of infants and young children that is an allergic reaction to mercury, is characterized by dusky pink discoloration of hands and feet with local swelling and intense itching, and is accompanied by insomnia[medicine.academic.ru]
  • […] cheeks and tip of the nose (4) failure to thrive (5) anorexia (6) generalized miliaria-type skin rashes (7) photophobia (8) loss of teeth with ulceration of the gums (9) behavioral changes, with listlessness, shyness, outbursts and irritability (10) insomnia[meducator3.net]
Paresthesia
  • Besides peripheral neuropathy (presenting as paresthesia or itching, burning or pain) and discoloration, swelling (edema) and desquamation may occur.[en.wikipedia.org]
  • In children, mercury toxicity may result in the rare syndrome of acrodynia, which is characterized by severe leg cramps, irritability, paresthesia, excessive perspiration, pruritus, and painful redness and peeling of the palms of the hands and soles of[freethesaurus.com]
  • Symptoms [ edit ] Besides peripheral neuropathy (presenting as paresthesia or itching , burning or pain ) and discoloration, swelling ( edema ) and desquamation may occur.[mashpedia.com]
  • […] encephalopathy Occupational (inhaled): pulmonary fibrosis, reduced sperm count, nasopharyngeal tumors Excessive exposure: 8 µg/L (blood) Severe poisoning: 500 µg/L (8-h urine) * Selenium Caustic burns, pneumonitis, hypotension Brittle hair and nails, red skin, paresthesia[emedicine.com]
  • Complications include the following (see Presentation): Acute perioral and facial paresthesias Visual-field constriction Respiratory distress and nonspecific dermatitis Extremity numbness eventually appears, along with headache, fatigue, and tremor Ataxia[emedicine.com]
Apathy
  • These include: depression, apathy, fretfulness, loss of appetite, social withdrawal, photophobia sweating, hypotonia, misery, slurring or loss of speech, and insomnia.[worldmercuryproject.org]
  • […] the extremities, scarlet coloration of the cheeks and nose, swollen and painful extremities, cold and clammy skin, profuse sweating, digestive disturbances, photophobia, polyneuritis, extreme irritability alternating with periods of listlessness and apathy[medical-dictionary.thefreedictionary.com]
  • Its symptoms, such as apathy, irritability and progressive loss of speech, are quite similar to those of children with autism. “We were simply blown away by the results,” Dr. Austin stated.[vaccinesafetycouncilminnesota.org]
  • Warkany and Hubbard, 8 in their series of 28 pediatric patients published in 1953, established the link between acrodynia (erythematous rash of palms and soles, anorexia, fatigue, irritability, apathy, photophobia, polydypsia, excessive sweating, and[doi.org]

Treatment

  • Removal of the inciting agent is the goal of treatment. Correcting fluid and electrolyte losses and rectifying any nutritional imbalances (vitamin-rich diets, vitamin-B complex) are of utmost importance in the treatment of the disease.[en.wikipedia.org]
  • Correcting fluid and electrolyte losses and rectifying any nutritional imbalances (vitamin-rich diets, vitamin-B complex) are of utmost importance in the treatment of the disease.[mashpedia.com]
  • The treatment for Acrodynia is determined based on the severity of the symptoms and the mode of toxic exposure. Generally, there is no specific treatment for a chronic exposure.[dovemed.com]
  • What is the treatment of acrodynia? The goal of treatment is to remove the mercury and correct any fluid or electrolyte imbalances.[dermnetnz.org]
  • In most cases, with a timely-appointed adequate treatment, the prognosis is quite favorable, but in severe cases (extremely rare) a lethal outcome is possible.[en.med-directory.com]

Prognosis

  • […] have excellent prognosis.[dovemed.com]
  • In most cases, with a timely-appointed adequate treatment, the prognosis is quite favorable, but in severe cases (extremely rare) a lethal outcome is possible.[en.med-directory.com]
  • Prognosis Symptoms gradually disappear as insidiously as they began. Recovery is complete in the vast majority of patients. Older children tend to have less morbidity. Death can result in 10% of cases.[emedicine.com]
  • (See Etiology and Prognosis.) Mercury may also be contained in some cosmetics, such as skin-lightening products.[emedicine.com]

Etiology

  • Abstract A superantigen or autoimmunity has been hypothesized to be the main cause of the Kawasaki's Disease but the etiology is unknown.[ncbi.nlm.nih.gov]
  • As far as the physician was concerned, however, it remained an enigma until recently; completely obscure with respect to etiology and recalcitrant to all forms of therapy, though many different agents were proposed.[pediatrics.aappublications.org]
  • Journal/Publication/Source: Abstract/Excerpt: "Abstract: A superantigen or autoimmunity has been hypothesized to be the main cause of the Kawasaki's Disease but the etiology is unknown.[library.iaomt.org]
  • Acrodynia is a disease of the nervous system of an unclear etiology that is characterized by behavioral changes, up to pronounced mental disorders.[en.med-directory.com]
  • IN 1948 Warkany and Hubbard 1 indicted mercury ingestion as an etiologic factor in acrodynia.[nejm.org]

Epidemiology

  • Medical literature, epidemiological findings, and some case reports have suggested that mercury may play a pathogenic role. Several patients with Kawasaki's Disease have presented with elevated urine mercury levels compared to matched controls.[ncbi.nlm.nih.gov]
  • Epidemiology Frequency United States Acrodynia was once widely prevalent; however, it is rare today, owing to the discontinued use of mercury in different preparations. International Acrodynia was especially common in Australia.[emedicine.com]
  • An epidemiological analysis of the ‘autism as mercury poisoning’ hypothesis. Int. Risk. Safety Med. 2008; 20 :135–40. [ Google Scholar ] Australian Bureau of Statistics. 4102.0— Australian Social Trends, 1998. 1998. .[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • PATHOPHYSIOLOGY: The most frequent sources of mercury prior to the legislated removal of the heavy metal from these preparations were calomel-containing anthelminthics, laxatives, diaper rinses, teething powders, fungicides in paint, repeated gamma-globulin[drstandley.com]
  • Pathophysiology The most frequent sources of mercury prior to the legislated removal of the heavy metal from these preparations were calomel-containing anthelminthics, laxatives, diaper rinses, teething powders, fungicides in paint, repeated gamma-globulin[emedicine.com]
  • Pathophysiology of essential hypertension. In: Massry SG, Glassock RJ, eds. Textbook of Nephrology. 3rd ed. Baltimore, MD: Williams & Wilkins; 1998:1169 Table 1.[pediatrics.aappublications.org]

Prevention

  • […] these articles: example of mercury poisoning In mercury poisoning …children, a disorder known as acrodynia, or “pink disease,” is believed to be caused by an organic mercury compound, phenylmercuric propionate, which is incorporated into house paints to prevent[britannica.com]
  • The presented pathogenetic model may lead to new preventive- and therapeutic strategies for Kawasaki's disease.[ncbi.nlm.nih.gov]
  • Acrodynia may be prevented by eliminating exposure to sources of mercury and other heavy metals. The following points may be considered towards preventing poisoning by these chemical compounds.[dovemed.com]
  • It can almost completely prevent methylmercury uptake by erythrocytes and hepatocytes. In the past, dimercaprol (British antilewisite; 2,3-dimer-capto-l-propanol) and D-penicillamine were the most popular treatment modalities.[en.wikipedia.org]
  • The presented pathogenetic model may lead to new preventive- and therapeutic strategies for Kawasaki's disease." Citation: Mutter J, Yeter D. Kawasaki's disease, acrodynia, and mercury. Curr Med Chem. 2008; 15(28):3000-10.[library.iaomt.org]

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