Manganese deposits in patients with biliary atresia after hepatic porto-enterostomy

Ikeda, Shinji; Sera, Yoshihisa; Yoshida, Mitsuhiro; Ohshiro, Hajime; Uchino, Shigehiko; Oka, Yoichiro; Lee, Kwang Jong; Kotera, Atsushi

doi:10.1016/s0022-3468(00)90212-4

Cited by 18 publications

(21 citation statements)

References 16 publications

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“…In previous investigations, whole blood Mn concentrations were reported to be 1.5±11.1 lg/dl in patients with chronic hepatic encephalopathy [8], and 1.2±9.6 lg/ dl in patients with biliary atresia who had undergone hepatic porto-enterostomy [6]. Because Mn values in our congenital PSVS cases with normal liver function were much less elevated, we believe that in general the degree of Mn elevation is related to severity of hepatic dysfunction.…”

Section: Discussionmentioning

confidence: 48%

Manganese elevations in blood of children with congenital portosystemic shunts

Mizoguchi

Nishimura

Ono

et al. 2001

European Journal of Pediatrics

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Section: Discussionmentioning

confidence: 48%

Manganese elevations in blood of children with congenital portosystemic shunts

Mizoguchi

Nishimura

Ono

et al. 2001

European Journal of Pediatrics

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“…Although ammonia is widely regarded to play a key role in the development of hepatic encephalopathy, 22 studies have shown that the severity of hepatic encephalopathy is not directly linked to ammonia concentrations 23,24 . This finding has lead to the suggestion that other substances and metabolic abnormalities are important in the pathogenesis of hepatic encephalopathy including Mn‐related neurological dysfunction 15,20,25 . A direct relationship among blood Mn concentration, MRI hyperintensity consistent with Mn deposition, and severity of encephalopathic score in humans has been identified 20,26…”

mentioning

confidence: 90%

Whole Blood Manganese Concentrations in Dogs with Congenital Portosystemic Shunts

Gow

Marques

Yool

et al. 2010

Veterinary Internal Medicne

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Background: Manganese (Mn) is an essential mineral that is a cofactor for many enzymes required in the synthesis of proteins, carbohydrates, and lipids. Because hepatic clearance is essential in Mn homeostasis, conditions in humans resulting in hepatic insufficiency including cirrhosis and both acquired and congenital portosystemic shunting have been reported to result in increased blood Mn concentrations and increased Mn content in the central nervous system. Because Mn toxicity causes neurologic disturbances, increased Mn concentrations have been implicated in the pathogenesis of hepatic encephalopathy.Hypotheses: Dogs with congenital portosystemic shunts (cPSS) have significantly higher whole blood Mn concentrations than do healthy dogs or those with nonhepatic illnesses.Animals: Eighteen dogs with cPSS, 26 dogs with nonhepatic illnesses, and 14 healthy dogs. Methods: Whole blood Mn was measured by graphite furnace atomic absorption spectrometry. The diagnosis of cPSS was made by ultrasonography or during celiotomy either by visual inspection of a shunting vessel or portovenography.Results: Dogs with a cPSS had significantly higher whole blood Mn concentrations than did healthy dogs and dogs with nonhepatic illnesses. Whole blood Mn concentrations were not significantly different between healthy dogs and dogs with nonhepatic illnesses.Conclusion and Clinical Importance: Dogs with a cPSS have significantly increased whole blood Mn concentrations. Additional studies are warranted to investigate the role of Mn in cPSS-associated hepatic encephalopathy.

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“…Hypermanganesemia can occur as a result of liver disease and decreased biliary excretion (Ikeda et al, 2000), as bile is the major excretory route for Mn. Patients on long-term PN may develop biliary stasis or obstructive jaundice (Angsten et al, 2012; Fallon et al, 2010; Graham et al, 1984; Jones et al, 1993; Pierro et al, 1989; Sax et al, 1986; Shattuck et al, 1993), resulting in excess tissue Mn accumulation (Alves et al, 1997; Fell et al, 1996; Ikeda et al, 2000; Witzleben et al, 1968).…”

Section: Modulating Factors Of Mn Induced Neurotoxicitymentioning

confidence: 99%

“…Patients on long-term PN may develop biliary stasis or obstructive jaundice (Angsten et al, 2012; Fallon et al, 2010; Graham et al, 1984; Jones et al, 1993; Pierro et al, 1989; Sax et al, 1986; Shattuck et al, 1993), resulting in excess tissue Mn accumulation (Alves et al, 1997; Fell et al, 1996; Ikeda et al, 2000; Witzleben et al, 1968). Elevated Mn levels have also been seen in patients suffering from chronic liver failure (with inability to excrete Mn via the biliary system) and undergoing PN supplementation (McKinney et al, 2004; Mehta and Reilly, 1990).…”

Section: Modulating Factors Of Mn Induced Neurotoxicitymentioning

confidence: 99%

Manganese in human parenteral nutrition: Considerations for toxicity and biomonitoring

et al. 2014

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The iatrogenic risks associated with excessive Mn administration in parenteral nutrition (PN) patients are well documented. Hypermanganesemia and neurotoxicity are associated with the duration of Mn supplementation, Mn dosage, as well as pathological conditions, such as anemia or cholestasis. Recent PN guidelines recommend the biomonitoring of patients if they receive Mn in their PN longer than 30 days. The data in the literature are conflicting about the method for assessing Mn stores in humans as a definitive biomarker of Mn exposure or induced-neurotoxicity has yet to be identified. The biomonitoring of Mn relies on the analysis of whole blood Mn (WB Mn) levels, which are highly variable among human population and are not strictly correlated with Mn-induced neurotoxicity. Alterations in dopaminergic (DAergic) and catecholaminergic metabolism have been studied as predictive biomarkers of Mn-induced neurotoxicity. Given these limitations, this review addresses various approaches for biomonitoring Mn exposure and neurotoxic risk.

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Manganese deposits in patients with biliary atresia after hepatic porto-enterostomy

Cited by 18 publications

References 16 publications

Manganese elevations in blood of children with congenital portosystemic shunts

Manganese elevations in blood of children with congenital portosystemic shunts

Whole Blood Manganese Concentrations in Dogs with Congenital Portosystemic Shunts

Manganese in human parenteral nutrition: Considerations for toxicity and biomonitoring

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