-acetyl-penicillamine has been successfully given to patients with mercury-induced neuropathies and chronic toxicity, although it is not approved for such uses. It has a less favorable adverse effect profile than meso 2,3-dimercaptosuccinic acid. Hemodialysis with and without the addition of L-cysteine as a chelating agent has been used in some patients experiencing acute kidney injury from mercury toxicity. Peritoneal dialysis and plasma exchange also may be of benefit. Tolazoline (Priscoline) has been shown to offer symptomatic relief from sympathetic overactivity. Antibiotics are necessary when massive hyperhidrosis, which may rapidly lead to miliaria rubra, is present. This can easily progress to bacterial secondary infection with a tendency for ulcerating pyoderma. Treatment The standard of care is discontinuation of the environmental exposure, and chelation therapy done safely with the Andrew Cutler Protocol, DMPS/DMSA and ALA taken orally in small doses according to their half-lives over a 72-hour period, followed by a three-day break. References External links Occupational diseases Toxicology Pediatrics