Effective treatment of manganese-induced occupational Parkinsonism with p-aminosalicylic acid: a case of 17-year follow-up study.
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.
Jiang
Yue-Ming
YM
Department of Occupational Health and Toxicology, Guangxi Medical University, China.
Mo
Xue-An
XA
Du
Feng-Qi
FQ
Fu
Xue
X
Zhu
Xia-Yan
XY
Gao
Hong-Yu
HY
Xie
Jin-Lan
JL
Liao
Feng-Ling
FL
Pira
Enrico
E
Zheng
Wei
W
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*
D010131:Aminosalicylic Acid