Pune: Doctors have found that a herbal powder taken for a facial white patch contained high levels of mercury, triggering severe hypertension and a rare brain condition in a nine-year-old girl in the city.Specialists at Sahyadri Manipal Hospital, Nagar Road, pointed out that the case highlights the risks of using unsupervised medication. The herbal powder, which the girl consumed for nearly three weeks, was sent to a laboratory for analysis after routine investigations failed to explain her condition.“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,” said senior paediatric intensivist Dr Sagar Lad. “Mercury is excreted through urine, making it a key diagnostic marker for exposure. The National Poisons Information Centre (NPIC) at AIIMS New Delhi also helped guide our diagnosis, which confirmed mercury poisoning as the primary cause.”He said the child was brought to the hospital in a state of coma, with altered consciousness, continuous refractory convulsion, severe headache, visual disturbances and sluggishly reacting pupils. Her blood pressure was extremely high — around 200 systolic and 120 diastolic — levels considered severe even in adults.MRI findings confirmed Posterior Reversible Encephalopathy Syndrome (PRES), a condition involving brain swelling typically linked to acute hypertension. However, despite emergency management and multiple medications, her blood pressure remained persistently elevated, prompting an extensive search for underlying causes.Doctors evaluated renal, cardiac and endocrine causes, including rare conditions such as pheochromocytoma, and also assessed renal arteries for narrowing. All tests were normal, creating a diagnostic dilemma.A detailed history from the family revealed that the child had been given a herbal powder to reduce a white patch on her face.“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,” Dr Lad said.Further evaluation confirmed mercury poisoning, a rare condition in children. Doctors said that while lead poisoning is relatively more common, mercury toxicity is seldom seen and can cause neurological symptoms, joint and muscle pain, and refractory hypertension through autonomic dysfunction.Dr Lad added, “Recognising the cause proved critical. We started chelation therapy for the child, beginning with injections for three to five days, followed by oral chelation for two weeks, based on guidance from the national toxicology centre.”Following treatment, the child showed marked improvement. Her blood pressure gradually normalised and all anti-hypertensive drugs were stopped. Repeat urine tests showed mercury levels dropping below 10 µg/L.“She made a complete neurological recovery and was back to her baseline — healthy, stable and symptom-free — by the time of discharge,” said senior paediatrician Dr Prateek Kataria, who also treated the child along with Dr Lad.
