title: Blood manganese levels in patients with hepatic encephalopathy.
abstract: METHODS
  Hepatic encephalopathy is an increasingly common disease. Identification of prognosis risk factors in patients with liver damage may lead to preventive actions, towards decreasing its mortality. Manganese (Mn) levels are increased in basal ganglia of patients with hepatic encephalopathy as well as in cases of cirrhotic and liver failure patients. The present is a clinical, prospective, prolective and observational study developed at the Internal Medicine Service from "Dr. Darío Fernández Fierro" General Hospital, ISSSTE, Mexico City. The objective of this work was to report whole blood Mn levels and mortality in encephalopathic patients.
  
  
  METHODS
  Consecutive patients over 18 years of age, diagnosed with hepatic encephalopathy were recruited at the emergency room service. An informed consent, signed by their families was collected. Patients' clinical characteristics, biochemical tests of renal function, hemoglobin, glucose, bilirubins and albumin levels were obtained along with a blood sample to analyze Mn. Patients evolution was followed up for 6 months.
  
  
  RESULTS
  Blood Mn in patients [median, (range)] [20.5, (10.5-39.5) μg/L] were higher than blood levels from a group of healthy volunteers [7.5, (6.1-12.8) μg/L] (P<0.001). Among 9 patients studied four died, 2 women and 2 men, those patients showed higher (P=0.032) Mn levels [28, (17-39.5) μg/L] than those alive [13.5, (10.5-32) μg/L] after the follow up period.
  
  
  CONCLUSIONS
  In this pilot study, Mn blood levels were higher in hepatic encephalopathy that died as consequence of the disease that those that survived in a 6 month follow up period. Blood Mn could be a potential prognosis factor for death in patients with hepatic encephalopathy.
authors.affiliation: Medical Research Center (CICMED), Autonomous University of the State of Mexico (UAEMEx), Materno Perinatal Hospital Mónica Pretelini (HMPMP), Asociación Científica Latina (ASCILA), Toluca, Mexico. mezh_74@yahoo.com
authors.forename: Hugo Mendieta
authors.initials: HM
authors.lastname: Zerón
authors.forename: Mónica Rodríguez
authors.initials: MR
authors.lastname: Rodríguez
authors.forename: Sergio
authors.initials: S
authors.lastname: Montes
authors.forename: Camilo Ríos
authors.initials: CR
authors.lastname: Castañeda
mesh_terms: D000368:Aged; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood* / Q000145:classification; D006801:Humans; D008297:Male; D008345:Manganese / Q000097:blood*; D008875:Middle Aged; D012015:Reference Standards
chemical_list: D008345:Manganese