Mercury-induced nephrotic syndrome: a case report and review of the literature.

A 42-year-old man was admitted to the Nephrology Department because of nephrotic syndrome. Eight months prior to admission he attempted suicide by intravenous self-injection of 2.5 ml of elemental mercury. Renal biopsy was performed. Light microscopy findings showed normal glomeruli and injury of proximal tubular cells. Immunofluorescence was negative, and electron microscopy study revealed diffuse effacement of podocyte foot processes and vacuolization of podocyte cytoplasm. Minimal change disease was diagnosed. The patient was treated with 2,3-dimercaptopropane-1-sulfonate, for mercury detoxification, and steroids. In one-year follow-up the 24-h urine protein excretion decreased from 30 γ to 0.186 g, and the renal function remain normal. The presented case indicates that mercury intoxication should be mentioned as a cause of secondary minimal change disease.