Abstract
The current practice of providing manganese supplementation to neonates on long term parenteral nutrition is leading to a high incidence of hypermanganesaemia. Magnetic resonance imaging (MRI) studies in adults on long term manganese parenteral nutrition have shown changes in TI weighted MRI images and similar findings in a neonate receiving trace element supplementation are reported here. Whole blood manganese concentration in the infant was 1740 nmol/l (or 8.3 times upper reference limit). In all neonates on long term parenteral nutrition with evidence of cholestatic liver disease so far investigated, the whole blood manganese concentrations were > 360 nmol/l (reference range 73-210). Manganese supplementation to patients on long term parenteral nutrition requires reappraisal, particularly in those who develop cholestatic liver disease associated with parenteral nutrition.
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Selected References
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- Ayotte P., Plaa G. L. Hepatic subcellular distribution of manganese in manganese and manganese-bilirubin induced cholestasis. Biochem Pharmacol. 1985 Nov 1;34(21):3857–3865. doi: 10.1016/0006-2952(85)90435-6. [DOI] [PubMed] [Google Scholar]
- Burch R. E., Sullivan J. F. Diagnosis of zinc, copper, and manganese abnormalities in man. Med Clin North Am. 1976 Jul;60(4):655–660. doi: 10.1016/s0025-7125(16)31850-8. [DOI] [PubMed] [Google Scholar]
- Ejima A., Imamura T., Nakamura S., Saito H., Matsumoto K., Momono S. Manganese intoxication during total parenteral nutrition. Lancet. 1992 Feb 15;339(8790):426–426. doi: 10.1016/0140-6736(92)90109-g. [DOI] [PubMed] [Google Scholar]
- Mirowitz S. A., Westrich T. J. Basal ganglial signal intensity alterations: reversal after discontinuation of parenteral manganese administration. Radiology. 1992 Nov;185(2):535–536. doi: 10.1148/radiology.185.2.1410368. [DOI] [PubMed] [Google Scholar]
- Mirowitz S. A., Westrich T. J., Hirsch J. D. Hyperintense basal ganglia on T1-weighted MR images in patients receiving parenteral nutrition. Radiology. 1991 Oct;181(1):117–120. doi: 10.1148/radiology.181.1.1909445. [DOI] [PubMed] [Google Scholar]