title: Effective treatment of manganese-induced occupational Parkinsonism with p-aminosalicylic acid: a case of 17-year follow-up study.
abstract: OBJECTIVE
  Chronic manganese (Mn) intoxication induces syndromes resembling Parkinson disease. The clinical intervention has largely been unsuccessful. We report a 17-year follow-up study of effective treatment of occupational Mn parkinsonism with sodium para-aminosalicylic acid (PAS).
  
  
  METHODS
  The patient, female and aged 50 at the time of treatment, was exposed to airborne Mn for 21 years (1963-1984). The patient had palpitations, hand tremor, lower limb myalgia, hypermyotonia, and a distinct festinating gait. She received 6 g PAS per day through an intravenous drip infusion for 4 days and rested for 3 days as one therapeutic course. Fifteen such courses were carried out between March and June 1987.
  
  
  RESULTS
  At the end of PAS treatment, her symptoms were significantly alleviated, and handwriting recovered to normal. Recent follow-up examination at age 67 years (in 2004) showed a general normal presentation in clinical, neurologic, brain magnetic resonance imaging, and handwriting examinations with a minor yet passable gait.
  
  
  CONCLUSIONS
  This case study suggests that PAS appears to be an effective drug for treatment of severe chronic Mn poisoning with a promising prognosis.
authors.affiliation: Department of Occupational Health and Toxicology, Guangxi Medical University, China.
authors.forename: Yue-Ming
authors.initials: YM
authors.lastname: Jiang
authors.forename: Xue-An
authors.initials: XA
authors.lastname: Mo
authors.forename: Feng-Qi
authors.initials: FQ
authors.lastname: Du
authors.forename: Xue
authors.initials: X
authors.lastname: Fu
authors.forename: Xia-Yan
authors.initials: XY
authors.lastname: Zhu
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Gao
authors.forename: Jin-Lan
authors.initials: JL
authors.lastname: Xie
authors.forename: Feng-Ling
authors.initials: FL
authors.lastname: Liao
authors.forename: Enrico
authors.initials: E
authors.lastname: Pira
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
mesh_terms: D010131:Aminosalicylic Acid / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020149:Manganese Poisoning / Q000150:complications*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000188:drug therapy*; D016273:Occupational Exposure; D020734:Parkinsonian Disorders / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D010131:Aminosalicylic Acid