Document Detail

Neurologic disorders due to brain manganese deposition in a jaundiced patient receiving long-term parenteral nutrition.
MedLine Citation:
PMID:  9002084     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Neurologic and radiologic disorders have been reported in patients receiving long-term parenteral nutrition (PN). On the basis of elevated serum manganese levels, some of these abnormalities have been attributed to manganese intoxication. Alterations of the basal ganglia signal intensity on T1-weighted magnetic resonance images (MRIs) have been previously reported, but the precise nature of these alterations remains controversial although the deposition of manganese has been suggested in patients with chronic hepatic encephalopathy due to liver failure. METHODS: We report the case of a patient who was receiving PN and exhibited a chronic cholestasis. Neurologic disorders appeared after several months of PN, when a hypersignal in the basal ganglia and white matter was found on T1-weighted MRIs of the brain in association with elevated serum and manganese levels. RESULTS: Elevated autopsic concentrations of manganese were found in the radiologic abnormal cerebral areas. CONCLUSIONS: Our observation is the first demonstration of a relationship between high intracerebral manganese levels, radiologic abnormalities, and neurologic disorders during long-term PN. Moreover, serum manganese levels are not a good indicator of cerebral levels. In fact, in our patient, serum manganese levels returned to normal, whereas those of cerebral manganese remained increased.
G Alves; J Thiebot; A Tracqui; T Delangre; C Guedon; E Lerebours
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  21     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    1997 Jan-Feb
Date Detail:
Created Date:  1997-03-25     Completed Date:  1997-03-25     Revised Date:  2007-02-21    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  41-5 )     Citation Subset:  IM    
GBPDN, Hôpital Charles Nicolle, Rouen, France.
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MeSH Terms
Brain / metabolism,  pathology*
Brain Chemistry*
Cholestasis / therapy*
Chronic Disease
Fatal Outcome
Manganese / administration & dosage,  blood
Manganese Poisoning*
Middle Aged
Nervous System Diseases / chemically induced*,  physiopathology
Parenteral Nutrition / adverse effects*
Reg. No./Substance:

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