Fredstrom S, Rogosheske J, Gupta P, Burns L J
Department of Medicine, University of Minnesota Medical School, Minneapolis 55455, USA.
Bone Marrow Transplant. 1995 Jun;15(6):989-92.
Neurologic syndromes attributed to conditioning or medications have been reported in BMT recipients. A patient is presented who developed extrapyramidal symptoms on day +56 after allogeneic BMT. Brain magnetic resonance images of this patient demonstrated hyperintense basal ganglia, which has been associated with manganese (Mn) toxicity. The patient had received total parenteral nutrition (TPN) with standard trace element supplementation and had been cholestatic. Serum Mn was elevated, and continued to be so 5 months after BMT, long after discontinuation of TPN. Cholestatic patients and those on long-term TPN have been found to have high blood or serum levels of Mn, but generally are asymptomatic. When other cholestatic BMT patients were reviewed, all had elevated serum Mn. Manganese supplementation in TPN requires evaluation for BMT recipients.
在骨髓移植（BMT）受者中，已报告有归因于条件作用或药物的神经系统综合征。本文介绍了一名在异基因BMT后第56天出现锥体外系症状的患者。该患者的脑部磁共振图像显示基底神经节高信号，这与锰（Mn）中毒有关。该患者接受了补充标准微量元素的全胃肠外营养（TPN），并且一直存在胆汁淤积。血清锰升高，在BMT后5个月仍然如此，此时TPN已停用很久。已发现胆汁淤积患者和长期接受TPN的患者血液或血清锰水平较高，但通常无症状。当对其他胆汁淤积性BMT患者进行复查时，发现他们的血清锰均升高。对于BMT受者，需要对TPN中的锰补充进行评估。
