{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T09:41:59Z","timestamp":1777110119508,"version":"3.51.4"},"reference-count":21,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Context.\u2014Public awareness of methylmercury in fish has caused patients to seek testing for mercury poisoning. In some patients, the diagnosis of mercury poisoning has been made based on urine mercury excretions following oral dosing of meso-dimercaptosuccinic acid (DMSA), a metal chelator. However, studies comparing urine mercury excretion following DMSA in healthy non\u2013fish eaters with healthy fish eaters could not be located.<\/jats:p>\n                  <jats:p>Objectives.\u2014To describe urinary mercury excretion before and after DMSA in healthy fish eaters and non\u2013fish eaters, and to determine whether urine mercury excretion after DMSA would rise above baseline levels to a greater extent in fish eaters.<\/jats:p>\n                  <jats:p>Design.\u2014A total of 24 healthy physicians were assigned to 1 of 3 groups based on fish consumption: non\u2013fish eaters; 1 to 2 fish servings per week; and 3 or more servings per week. Blood mercury concentrations and 12-hour urine mercury and creatinine excretions were measured before and after oral ingestion of 30 mg of DMSA per kilogram of body weight.<\/jats:p>\n                  <jats:p>Results.\u2014A total of 24 subjects completed the study, and 2 subsequently were excluded. No difference in baseline urinary mercury excretion was detected between groups. All groups demonstrated an increase in urinary mercury excretion following DMSA, which was higher in fish eaters (P = .04). Multiple linear regression found that the best predictor of a rise in urine mercury excretion following DMSA challenge was the prechelation blood mercury concentration.<\/jats:p>\n                  <jats:p>Conclusions.\u2014In this study of healthy physicians, oral DMSA produced a rise in urine mercury excretion both in non\u2013fish eaters and fish eaters. The increase in chelated mercury excretion was higher in fish eaters. A simple rise in chelated mercury excretion over baseline excretion is not a reliable diagnostic indicator of mercury poisoning.<\/jats:p>","DOI":"10.5858\/133.1.87","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T07:58:13Z","timestamp":1613116693000},"page":"87-92","source":"Crossref","is-referenced-by-count":10,"title":["Urine Mercury Excretion Following\n                    <i>meso<\/i>\n                    -Dimercaptosuccinic Acid Challenge in Fish Eaters"],"prefix":"10.5858","volume":"133","author":[{"given":"Anne-Michelle","family":"Ruha","sequence":"first","affiliation":[{"name":"From the Department of Medical Toxicology, Banner Good Samaritan Medical Center (Drs Ruha, Curry, and Gerkin), the Department of Emergency Medicine, Maricopa Medical Center (Drs Ruha, Curry, and Gerkin), and the Departments of Emergency Medicine (Dr Ruha) and Medicine (Dr Curry), University of Arizona College of Medicine, Phoenix; the Division of Laboratory Sciences, National Center for Environme"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven C.","family":"Curry","sequence":"additional","affiliation":[{"name":"From the Department of Medical Toxicology, Banner Good Samaritan Medical Center (Drs Ruha, Curry, and Gerkin), the Department of Emergency Medicine, Maricopa Medical Center (Drs Ruha, Curry, and Gerkin), and the Departments of Emergency Medicine (Dr Ruha) and Medicine (Dr Curry), University of Arizona College of Medicine, Phoenix; the Division of Laboratory Sciences, National Center for Environme"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard D.","family":"Gerkin","sequence":"additional","affiliation":[{"name":"From the Department of Medical Toxicology, Banner Good Samaritan Medical Center (Drs Ruha, Curry, and Gerkin), the Department of Emergency Medicine, Maricopa Medical Center (Drs Ruha, Curry, and Gerkin), and the Departments of Emergency Medicine (Dr Ruha) and Medicine (Dr Curry), University of Arizona College of Medicine, Phoenix; the Division of Laboratory Sciences, National Center for Environme"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen L.","family":"Caldwell","sequence":"additional","affiliation":[{"name":"From the Department of Medical Toxicology, Banner Good Samaritan Medical Center (Drs Ruha, Curry, and Gerkin), the Department of Emergency Medicine, Maricopa Medical Center (Drs Ruha, Curry, and Gerkin), and the Departments of Emergency Medicine (Dr Ruha) and Medicine (Dr Curry), University of Arizona College of Medicine, Phoenix; the Division of Laboratory Sciences, National Center for Environme"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Osterloh","sequence":"additional","affiliation":[{"name":"From the Department of Medical Toxicology, Banner Good Samaritan Medical Center (Drs Ruha, Curry, and Gerkin), the Department of Emergency Medicine, Maricopa Medical Center (Drs Ruha, Curry, and Gerkin), and the Departments of Emergency Medicine (Dr Ruha) and Medicine (Dr Curry), University of Arizona College of Medicine, Phoenix; the Division of Laboratory Sciences, National Center for Environme"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Wax","sequence":"additional","affiliation":[{"name":"From the Department of Medical Toxicology, Banner Good Samaritan Medical Center (Drs Ruha, Curry, and Gerkin), the Department of Emergency Medicine, Maricopa Medical Center (Drs Ruha, Curry, and Gerkin), and the Departments of Emergency Medicine (Dr Ruha) and Medicine (Dr Curry), University of Arizona College of Medicine, Phoenix; the Division of Laboratory Sciences, National Center for Environme"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"key":"2021021102003738000_i1543-2165-133-1-87-b1","article-title":"Mercury levels in commercial fish and shellfish. May 2001 (updated February 2006).","author":"US Department of Health and Human Services and US Environmental Protection Agency."},{"key":"2021021102003738000_i1543-2165-133-1-87-b2","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1006\/taap.1996.0078","article-title":"Methyl mercury pharmacokinetics in man: a reevaluation.","volume":"137","author":"Smith","year":"1996","journal-title":"Toxicol Appl Pharmacol"},{"key":"2021021102003738000_i1543-2165-133-1-87-b3","article-title":"Backgrounder for the 2004 FDA\/EPA consumer advisory: what you need to know about mercury in fish and shellfish.","author":"US Food and Drug Administration."},{"key":"2021021102003738000_i1543-2165-133-1-87-b4","article-title":"Report: Fish-mercury risk underestimated.","author":"CNN.com\/Health."},{"key":"2021021102003738000_i1543-2165-133-1-87-b5","article-title":"Mercury in 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