Case links CASPR2 autoimmune encephalitis to mercury exposure

A case report describes a 2-year-old girl exposed to elemental mercury from a household spill who developed acrodynia and persistent altered mental status despite chelation therapy and normalization of urine mercury levels. Testing identified CASPR2 IgG antibodies, and the report states her symptoms improved after treatment with intravenous immunoglobulin and corticosteroids. The authors describe CASPR2-IgG autoimmune encephalitis as a rare complication of elemental mercury intoxication in which neuropsychiatric symptoms can persist despite chelation and systemic mercury clearance.

Most relevant for: Pediatric patients with elemental mercury exposure who have persistent neuropsychiatric symptoms after chelation therapy.

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