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.
|Plasma||:|| <10 nmol/L
|Whole blood||:||80-200 nmol/L|
Trace element free (royal blue top) preferred, EDTA (lavender top) acceptable