Manganese in long term paediatric parenteral nutrition.
The current practice of providing manganese supplementation to neonates on long term parenteral nutrition is leading to a high incidence of hypermanganesaemia. Magnetic resonance imaging (MRI) studies in adults on long term manganese parenteral nutrition have shown changes in TI weighted MRI images and similar findings in a neonate receiving trace element supplementation are reported here. Whole blood manganese concentration in the infant was 1740 nmol/l (or 8.3 times upper reference limit). In all neonates on long term parenteral nutrition with evidence of cholestatic liver disease so far investigated, the whole blood manganese concentrations were > 360 nmol/l (reference range 73-210). Manganese supplementation to patients on long term parenteral nutrition requires reappraisal, particularly in those who develop cholestatic liver disease associated with parenteral nutrition.
Reynolds
A P
AP
Great Ormond Street Hospital for Children NHS Trust, London.
Kiely
E
E
Meadows
N
N
D002779:Cholestasis / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D008134:Long-Term Care; D008345:Manganese / Q000097:blood*; D010288:Parenteral Nutrition / Q000009:adverse effects*
D008345:Manganese