Imperial Collage Healthcare


Test Background
Manganese is a trace element that is an essential co-factor for several enzymes, including one form of superoxide dismutase, gluconeogenic enzymes, pyruvate carboxylase and isocitrate dehydrogenase. It circulates as a metalloprotein complex with any of several proteins. Manganese toxicity due to environmental causes primarily affects the CNS and liver. Elevated levels of whole blood manganese have been reported, with and without CNS symptoms, in patients with hepatitis B virus-induced liver cirrhosis, in patients on total parenteral nutrition (TPN) with manganese supplementation and in infants born to mothers who were on TPN. Behçet disease, a form of chronic systemic vasculitis, exhibits an increased erythrocyte manganese, and it is suggested that increased activity of superoxide dismutase may contribute to the pathogenesis of the disease.

Clinical Indications
Evaluation of CNS symptoms similar to Parkinson’s disease Characterisation of liver cirrhosis Therapeutic monitoring in treatment of cirrhosis Parenteral nutrition-related manganese toxicity and environmental exposure to manganese Supportive of diagnosis of Behçet disease

Reference Range
Plasma: <10 nmol/L Whole blood: 80-200 nmol/L

Sample Required
Trace element free (royal blue top) preferred, EDTA (lavender top) acceptable

Sample Volume
0.5 mL

Turnaround Time
2 weeks

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