Another umbrella murder? - A rare case of Minamata disease

Abstract

We report a rare case of fatal intoxication in a 40-year-old man caused by injection of a fluid containing organic mercury, allegedly in an attack with a syringe fixed to the tip of an umbrella. The man suffered from severe neurological symptoms and progressive multiorgan failure and died 10 months later in refractory status epilepticus. Autopsy revealed severe brain atrophy and non-specific kidney damage. Neuropathological examination showed neuronal loss especially in the occipital lobe, distinct granule cell necrosis in the cerebellum and Wallerian degeneration in the brainstem. Postmortem toxicological analysis revealed extremely increased levels of mercury in liver and kidney tissue as well as methylmercury levels in peripheral blood.

Keywords: Methylmercury; Minamata disease; Neuropathological alterations; Umbrella murder.

Fig. 1

Abundant microglial cells and macrophages in the occipital cerebral white matter (Anti-CD68, original magnification ×100)

Fig. 2

Wallerian degeneration in the pontine tracts with abundant pale macrophages (HE, original magnification ×200)

Fig. 3

Cerebellar hemisphere with loss of granular cells and Purkinje-cells (HE, original magnification ×200)

Fig. 4

Dentate nucleus with loss of neurons and with macrophages in the white matter (HE, original magnification ×200)