Manganese intoxication and chronic liver failure

RA Hauser, TA Zesiewicz… - Annals of Neurology …, 1994 - Wiley Online Library
RA Hauser, TA Zesiewicz, AS Rosemurgy, C Martinez, CW Olanow
Annals of Neurology: Official Journal of the American Neurological …, 1994Wiley Online Library
Manganese intoxication and chronic liver failure are associated with strikingly similar
clinical, imaging, and pathological abnormalities. As manganese is primarily cleared by the
liver, inadequate elimination of manganese absorbed from the normal diet may lead to
manganese overload in patients with liver disease. We report a significant elevation of blood
manganese concentration in 3 patients with biopsy‐proved hepatic cirrhosis who exhibited
neurological dysfunction and characterstic abnormal signal hyperintensity in the globi pallidi …
Abstract
Manganese intoxication and chronic liver failure are associated with strikingly similar clinical, imaging, and pathological abnormalities. As manganese is primarily cleared by the liver, inadequate elimination of manganese absorbed from the normal diet may lead to manganese overload in patients with liver disease. We report a significant elevation of blood manganese concentration in 3 patients with biopsy‐proved hepatic cirrhosis who exhibited neurological dysfunction and characterstic abnormal signal hyperintensity in the globi pallidi and substantia nigra on T1‐weighted magnetic resonance imaging. We speculate that manganese accumulation in the brain accounts for the magnetic resonance imaging abnormalities and contributes to neurological dysfunction in patients with liver disease.
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