Manganese toxicity - Revision history

Elcatracho: /* Disposition */

2021-03-09T06:45:35Z

Disposition

← Older revision		Revision as of 06:45, 9 March 2021
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	*Will depend on severity, most cases are likely seen in patients receiving TPN, and will likely need changes to their TPN orders and a consultation from nutrition		*Will depend on severity, most cases are likely seen in patients receiving TPN, and will likely need changes to their TPN orders and a consultation from nutrition
	*Consult Toxicology or [[poison control]]		*Consult Toxicology or [[poison control]]

			==See Also==
			*[[Toxicology (main)]]
			*[[Heavy metals]]

	==References==		==References==

Elcatracho: /* Background */

2021-03-09T06:44:48Z

Background

← Older revision		Revision as of 06:44, 9 March 2021
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	***Seen in industrial areas as manganese is used to make steel		***Seen in industrial areas as manganese is used to make steel
	**Parenteral nutrition (TPN)		**Parenteral nutrition (TPN)
	**IV Methcathinone		**[[Synthetic cathinone toxicity\|IV Methcathinone]]
	*Readily crosses the blood brain barrier and can be seen concentrated in the basal ganglia, particularly the globus pallidus		*Readily crosses the blood brain barrier and can be seen concentrated in the basal ganglia, particularly the globus pallidus

	==Clinical Features==		==Clinical Features==

SeanDenny: /* Clinical Features */

2020-12-15T00:34:03Z

Clinical Features

← Older revision		Revision as of 00:34, 15 December 2020
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	***[[ataxia\|Gait disturbances]]		***[[ataxia\|Gait disturbances]]
	***Low volume speech		***Low volume speech
	***Can mimic [[~~Parkinson’s~~ disease]]		***Can mimic [[Parkinson's disease]]
	*Pulmonary		*Pulmonary
	**Acute / [[Metal fume fever]]		**Acute / [[Metal fume fever]]

ClaireLewis at 22:51, 2 October 2019

2019-10-02T22:51:18Z

← Older revision		Revision as of 22:51, 2 October 2019
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	**IV Methcathinone		**IV Methcathinone
	*Readily crosses the blood brain barrier and can be seen concentrated in the basal ganglia, particularly the globus pallidus		*Readily crosses the blood brain barrier and can be seen concentrated in the basal ganglia, particularly the globus pallidus

	==Clinical Features==		==Clinical Features==
	*Toxicity typically presents as cognitive issues		*Toxicity typically presents as cognitive issues
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	**Acute		**Acute
	***“Manganese madness”		***“Manganese madness”
	***Visual [[hallucinations		***Visual [[hallucinations]]
	***Behavioral changes		***Behavioral changes
	***Anxiety		***[[Anxiety]]
	***Impotence		***Impotence
	**Late ~~Manifestations~~		**Late manifestations
	***Tremor		***[[Tremor]]
	***[[dysarthria\|Impaired speech]]		***[[dysarthria\|Impaired speech]]
	***Loss of facial expressions		***Loss of facial expressions
	***Gait disturbances		***[[ataxia\|Gait disturbances]]
	***Low volume speech		***Low volume speech
	***Can mimic ~~parkinson’s~~ disease		***Can mimic [[Parkinson’s disease]]
	*Pulmonary		*Pulmonary
	**Acute / [[Metal ~~Fume Fever~~]]		**Acute / [[Metal fume fever]]
	***[[Fever]]		***[[Fever]]
	***[[Nausea]]		***[[Nausea]]
Line 57:		Line 58:
	**No definite toxic level		**No definite toxic level
	**Elevated levels are typically seen in acute toxicity, as manganese is quickly cleared from the blood		**Elevated levels are typically seen in acute toxicity, as manganese is quickly cleared from the blood
	*MRI		*[[brain MRI\|MRI]]
	**Will show abnormal T1- weighted signal hyperintensity in the basal ganglia, particularly in the globus pallidus, with normal T2-weighted images		**Will show abnormal T1- weighted signal hyperintensity in the basal ganglia, particularly in the globus pallidus, with normal T2-weighted images

Line 63:		Line 64:
	*Supportive care		*Supportive care
	*Remove source of exposure		*Remove source of exposure
	*Chelation therapy with CaNa<sub>2</sub>EDTA or DTPA		*Chelation therapy with CaNa<sub>2</sub>[[EDTA]] or DTPA
	**Can improve urinary excretion of manganese without affecting the neurologic manifestations		**Can improve urinary excretion of manganese without affecting the neurologic manifestations

ClaireLewis at 15:25, 27 August 2019

2019-08-27T15:25:41Z

← Older revision		Revision as of 15:25, 27 August 2019
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	**Acute		**Acute
	***“Manganese madness”		***“Manganese madness”
	***Visual hallucinations		***Visual [[hallucinations
	***Behavioral changes		***Behavioral changes
	***Anxiety		***Anxiety
Line 22:		Line 22:
	**Late Manifestations		**Late Manifestations
	***Tremor		***Tremor
	***Impaired speech		***[[dysarthria\|Impaired speech]]
	***Loss of facial expressions		***Loss of facial expressions
	***Gait disturbances		***Gait disturbances
Line 28:		Line 28:
	***Can mimic parkinson’s disease		***Can mimic parkinson’s disease
	*Pulmonary		*Pulmonary
	**Acute / Metal Fume Fever		**Acute / [[Metal Fume Fever]]
	***Fever		***[[Fever]]
	***Nausea		***[[Nausea]]
	***Headache		***[[Headache]]
	***~~Myalgias~~		***[[Myalgia]]
	***~~Arthralgias~~		***[[Arthralgia]]
	**Chronic		**Chronic
	***Persistent dry cough		***Persistent dry [[cough]]
	***Bronchitis		***[[Bronchitis]]
	***Chemical pneumonitis		***Chemical [[pneumonitis]]
	*GI		*GI
	**Anorexia		**Anorexia
	*Musculoskeletal		*Musculoskeletal
	**~~Arthalgias~~		**[[Arthralgia]]
	**Muscle rigidity		**Muscle rigidity
	*Constitutional		*Constitutional
	**Lethargy		**[[Lethargy]]
	**Asthenia		**[[Weakness\|Asthenia]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Elevated levels are typically seen in acute toxicity, as manganese is quickly cleared from the blood		**Elevated levels are typically seen in acute toxicity, as manganese is quickly cleared from the blood
	*MRI		*MRI
	**Will show abnormal T1- weighted signal ~~hyperintisitiy~~ in the basal ganglia, ~~particuarly~~ in the globus pallidus, with normal T2-weighted images		**Will show abnormal T1- weighted signal hyperintensity in the basal ganglia, particularly in the globus pallidus, with normal T2-weighted images

	==Management==		==Management==
	*Supportive care		*Supportive care

Rossdonaldson1: Text replacement - "Poison Control Center" to "poison control"

2018-08-13T19:17:05Z

Text replacement - "Poison Control Center" to "poison control"

← Older revision		Revision as of 19:17, 13 August 2018
Line 67:		Line 67:
	==Disposition==		==Disposition==
	*Will depend on severity, most cases are likely seen in patients receiving TPN, and will likely need changes to their TPN orders and a consultation from nutrition		*Will depend on severity, most cases are likely seen in patients receiving TPN, and will likely need changes to their TPN orders and a consultation from nutrition
	*Consult Toxicology or ~~Poison Control Center~~		*Consult Toxicology or [[poison control]]

	==References==		==References==

Rossdonaldson1: /* Differential Diagnosis */

2018-08-12T22:30:01Z

Differential Diagnosis

@@ Line 48: / Line 48: @@
 ==Differential Diagnosis==
-===[[Heavy metal]] toxicity===
+{{Heavy metals list}}
 ==Evaluation==

Therriac at 00:38, 8 August 2018

2018-08-08T00:38:20Z

← Older revision		Revision as of 00:38, 8 August 2018
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	<references/>		<references/>
	Soghoian, S. Manganese. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1294-1298		Soghoian, S. Manganese. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1294-1298

			[[Category:Toxicology]]

Therriac: Created page with "==Background== *An essential element in the diet Used in various enzymatic processes Mn²⁺ can take the place of Mg²⁺, Ca²⁺, and Fe^2+<..."

2018-07-31T20:05:05Z

Created page with "==Background== *An essential element in the diet **Used in various enzymatic processes **Mn2+ can take the place of Mg2+, Ca2+, and Fe2+<..."

New page

==Background==
*An essential element in the diet
**Used in various enzymatic processes
**Mn2+ can take the place of Mg2+, Ca2+, and Fe2+ in various proteins and enzymes, and has been seen to replace Fe2+ in Hgb
**Low enteral absorption
**Cleared by the liver and excreted in the bile
*Typical routes of exposure
**Inhalation of dusts/fumes
***Seen in industrial areas as manganese is used to make steel
**Parenteral nutrition (TPN)
**IV Methcathinone
*Readily crosses the blood brain barrier and can be seen concentrated in the basal ganglia, particularly the globus pallidus
==Clinical Features==
*Toxicity typically presents as cognitive issues
*Neuropsychiatric
**Acute
***“Manganese madness”
***Visual hallucinations
***Behavioral changes
***Anxiety
***Impotence
**Late Manifestations
***Tremor
***Impaired speech
***Loss of facial expressions
***Gait disturbances
***Low volume speech
***Can mimic parkinson’s disease
*Pulmonary
**Acute / Metal Fume Fever
***Fever
***Nausea
***Headache
***Myalgias
***Arthralgias
**Chronic
***Persistent dry cough
***Bronchitis
***Chemical pneumonitis
*GI
**Anorexia
*Musculoskeletal
**Arthalgias
**Muscle rigidity
*Constitutional
**Lethargy
**Asthenia

==Differential Diagnosis==
===[[Heavy metal]] toxicity===
*[[Aluminum toxicity]]
*[[Antimony toxicity]]
*[[Arsenic toxicity]]
*[[Barium toxicity]]
*[[Bismuth toxicity]]
*[[Cadmium toxicity]]
*[[Chromium toxicity]]
*[[Cobalt toxicity]]
*[[Copper toxicity]]
*[[Gold toxicity]]
*[[Iron toxicity]]
*[[Lead toxicity]]
*[[Lithium toxicity]]
*[[Manganese toxicity]]
*[[Mercury toxicity]]
*[[Nickel toxicity]]
*[[Phosphorous toxicity]]
*[[Platinum toxicity]]
*[[Selenium toxicity]]
*[[Silver toxicity]]
*[[Thallium toxicity]]
*[[Tin toxicity]]
*[[Zinc toxicity]]

==Evaluation==
*Lab
**Whole blood 4-15 μg/L (73-273 nmol/L)
**Serum 0.9-2.9 μg/L (16-52 nmol/L)
**Urine (24h) <10 μg/L (182 nmol/L)
**No definite toxic level
**Elevated levels are typically seen in acute toxicity, as manganese is quickly cleared from the blood
*MRI
**Will show abnormal T1- weighted signal hyperintisitiy in the basal ganglia, particuarly in the globus pallidus, with normal T2-weighted images
==Management==
*Supportive care
*Remove source of exposure
*Chelation therapy with CaNa2EDTA or DTPA
**Can improve urinary excretion of manganese without affecting the neurologic manifestations

==Disposition==
*Will depend on severity, most cases are likely seen in patients receiving TPN, and will likely need changes to their TPN orders and a consultation from nutrition
*Consult Toxicology or Poison Control Center

==References==
<references/>
Soghoian, S. Manganese. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1294-1298