Minimal change disease following exposure to mercury-containing skin lightening cream

HL Tang, KH Chu, YF Mak, W Lee, A Cheuk, KF Yim, KS Fung, HWH Chan, KL Tong
Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong

A 34-year-old woman developed nephrotic syndrome after using a skin lightening cream that contained an extremely high level of mercury. Blood and urine mercury levels were elevated and a renal biopsy revealed minimal change disease. Membranous nephropathy was excluded using immunofluorescence and electron microscopy. Her proteinuria remitted 9 months after she stopped using the cosmetic cream. This is the first reported case in the English literature of proven minimal change disease secondary to mercury exposure. It is important that mercury poisoning due to cosmetic cream is considered in the differential diagnoses for any woman who presents with nephrotic syndrome.

Hong Kong Med J 2006;12:316-8

Key words: Cosmetics; Glomerulonephritis; Mercury; Nephrotic syndrome; Skin/drug effects