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Brain Manganese Deposition and Blood Levels in Patients Undergoing Home Parenteral Nutrition
Author(s) -
Boggio Bertinet Daniela,
Tinivella Marco,
Alessandro Balzola Federico,
de Francesco Antonella,
Davini Ottavio,
Rizzo Laura,
Massarenti Paola,
Antonietta Leonardi Maria,
Balzola Franco
Publication year - 2000
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607100024004223
Subject(s) - parenteral nutrition , gastroenterology , medicine , magnetic resonance imaging , anesthesia , radiology
Background : Extrapyramidal syndrome and alterations in brain magnetic resonance images are described in patients undergoing long‐term home parenteral nutrition (HPN) and in cholestatic patients. These abnormalities have been correlated to basal ganglia manganese (Mn) accumulation. Methods: A longitudinal 1‐year study was conducted on 15 patients undergoing HPN (median duration, 3.8 years; range, 1.7–10; median Mn parenteral supplementation, 0.1 mg/d). Whole‐blood, plasma, intra‐erythrocytes, and urinary Mn concentrations were measured and brain magnetic resonance was performed at the beginning (time 0) and after 1 year of Mn intravenous supplementation withdrawal (time 1). No patients showed psychosis, extrapyramidal syndrome, or cholestasis. Results: At time zero, 10 of 15 patients (67%) showed paramagnetic accumulation on cerebral magnetic resonance images; at time 1 there was a reduction of cerebral Mn accumulation. In all patients, blood‐Mn levels were significantly reduced after 1 year of Mn intravenous supplementation withdrawal. Conclusions: Patients receiving long‐term HPN showed an elevated incidence of alterations in brain magnetic resonance images with a median Mn intravenous supplementation of 0.1 mg/d. Mn supplementation withdrawal significantly decreased metal levels in blood and brain storage. We noticed that the intra‐erythrocyte Mn level was a good index of Mn status. (Journal of Parenteral and Enteral Nutrition 24:223–227, 2000)