Document Detail

Factors associated to hypermanganesemia in patients receiving home parenteral nutrition.
MedLine Citation:
PMID:  11031073     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Home parenteral nutrition (HPN) patients often present hypermanganesamia. AIM: To examine which factors may be associated to hypermanganesemia in HPN patients. METHODS: Plasma manganese (Mn), liver function tests, C-reactive protein concentrations, erythrocyte sedimentation rate (ESR), tumor necrosis factor-alpha (TNF- alpha), interleukin-6, soluble receptors of interleukin-2, and blood neopterin concentrations were determined in 21 HPN patients and 10 healthy controls. Brain magnetic resonance imaging (MRI) and careful neurologic clinical examination were performed in 11 patients. RESULTS: Mn concentration was higher in HPN patients than controls (1.96+/-1.1 vs 0.81+/- 0.4 microg/L;P<0.001) and positively correlated to the amount of parenteral nutrition (PN) supply, transaminases and alkaline phosphatase (r=0.53, P<0.0001) concentrations, as well as to ESR (r=0.61, P<0.0001), TNF- alpha and blood neopterin. The amount of calories provided by PN was positively correlated to inflammatory markers and liver parameters. All patients investigated by MRI showed hyperintense basal ganglia on T1-weighted images suggesting brain Mn deposition. Only one had slight clinical extrapyramidal symptoms. CONCLUSION: In HPN patients, sustained inflammation may facilitate hypermanganesemia through 1. cholestatic liver disease and thereby decreased Mn biliary excretion, 2. high nutritional requirements (responsible for increased Mn supply), and/or 3. modified Mn metabolism or body distribution. Neurologic complications appeared marginal whereas Mn brain deposition seems frequent.
J M Reimund; J L Dietemann; J M Warter; R Baumann; B Duclos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  19     ISSN:  0261-5614     ISO Abbreviation:  Clin Nutr     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-11-22     Completed Date:  2001-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  SCOTLAND    
Other Details:
Languages:  eng     Pagination:  343-8     Citation Subset:  IM    
Copyright Information:
Copyright 2000 Harcourt Publishers Ltd.
Service d'Hépato-Gastroentérologie et d'Assistance Nutritive, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France.
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MeSH Terms
Blood Sedimentation
C-Reactive Protein
Cholestasis / complications
Interleukins / analysis
Liver Function Tests
Magnetic Resonance Imaging
Manganese / blood*,  metabolism
Middle Aged
Neopterin / blood
Parenteral Nutrition, Home / adverse effects*
Prospective Studies
Risk Factors
Tumor Necrosis Factor-alpha / analysis
Reg. No./Substance:
0/Interleukins; 0/Tumor Necrosis Factor-alpha; 670-65-5/Neopterin; 7439-96-5/Manganese; 9007-41-4/C-Reactive Protein

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