Ono J, Harada K, Kodaka R, Sakurai K, Tajiri H, Takagi Y, Nagai T, Harada T, Nihei A, Okada A
Department of Pediatrics, Osaka University Medical School, Japan.
JPEN J Parenter Enteral Nutr. 1995 Jul-Aug;19(4):310-2. doi: 10.1177/0148607195019004310.
Manganese deposition was suspected in a pediatric patient who received long-term total parenteral nutrition. T1-weighted magnetic resonance images revealed high intensity areas in the globus pallidus. This study was designed to clarify if these abnormal findings were related to manganese deposition and clinical neurological manifestations.
Whole-blood manganese concentrations were measured during manganese supplementation to total parenteral nutrition and after 5 months without manganese. Magnetic resonance images were also examined on each occasion and compared with the blood level of manganese.
The whole-blood manganese level during supplementation was 135 micrograms/L (normal range 14.6 +/- 4.7 micrograms/L), whereas the level was 20 micrograms/L after a manganese-free period of 5 months. Accompanied with normalization of manganese level, abnormal high intensity lesions in the globus pallidus on T1-weighted images also disappeared. No neurological manifestation related to the high manganese level was recognized.
It is probable that the high manganese level was elicited by manganese supplementation to total parenteral nutrition. This high manganese condition was confirmed by the measurement of whole-blood manganese level, which was associated with the abnormal high intensity lesions on T1-weighted magnetic resonance images.
一名接受长期全胃肠外营养的儿科患者被怀疑有锰沉积。T1加权磁共振图像显示苍白球有高强度区域。本研究旨在阐明这些异常发现是否与锰沉积及临床神经学表现有关。
在全胃肠外营养补充锰期间及停止补充锰5个月后测量全血锰浓度。每次均检查磁共振图像并与锰的血药浓度进行比较。
补充锰期间全血锰水平为135微克/升（正常范围14.6±4.7微克/升），而在5个月无锰期后该水平为20微克/升。随着锰水平恢复正常，T1加权图像上苍白球的异常高强度病变也消失了。未发现与高锰水平相关的神经学表现。
全胃肠外营养补充锰可能导致了高锰水平。通过测量全血锰水平证实了这种高锰状态，其与T1加权磁共振图像上的异常高强度病变相关。
