Abstract
Chronic mercury poisoning from cosmetics is often misdiagnosed and mistreated due to atypical clinical presentations and high industrial standards and quality control of cosmetic products. Here we present a case of a 45-year-old female with a four-month history of progressive weakness, atrophy, insomnia, mood swings, chorea-like movement, extremity pain and hyperalgesia. The routine workup for neuropathy and myopathy such as CK, EMG were unremarkable. However heavy metal screen revealed significantly elevated mercury levels. Afterwards, we found it was caused by daily-use whitening cosmetics through the hair segmented toxicant analysis to trace the dynamics changing of mercury concentration in the body. After the removal of the patient from the source of exposure, and chelation therapy, her symptoms had gradually improved. When patients have unexplained behavioral changes, cognitive decline, sleep disturbance, fatigue, pain, and other unspecific manifestations, the possibility of mercury poisoning should be considered, blood mercury and urine mercury should be detected, and the source of exposure should be investigated and timely treatment should be given.