Whole blood manganese

The first report of abnormal manganese concentrations in human epileptics was published in 1967 and indicated high serum manganese concentrations in epileptics compared to non-epileptic controls (4). The authors were apparently unaware of the previous animal work that demonstrated a link between manganese deficiency and increased susceptibility to seizure. It was not until 1978 that Tanaka ( 5) presented data indicating that whole blood manganese concentrations were lower in epileptic children than in control children of similar age. A year later Papavasiliou and coworkers (6) in a study of 52... 

Table I. Correlation Between Whole Blood Manganese Concentration and Plasma Anticonvulsant Concentrations in Epileptic Patients...

Figure 1. Whole blood manganese levels in epileptic patients vs. medication index. Whole blood manganese was measured by atomic absorption spectrophotometry. The medication index is a composite measure of anticonvulsant concentrations in plasma as a relationship of each anticonvulsant to its therapeutic range. The medication index increases as a function of the relative concentration of each anticonvulsant and as a sum of all anticonvulsant concentrations. There was no correlation between whole blood manganese and medication index (r = -0.236.)...

Whole blood levels of manganese reflected differences in levels of dietary manganese. As shown in Figure 6, whole blood manganese concentrations of rats fed both low fat and high fat diets tended to increase as level of dietary manganese increased. 

Figure 6. Whole blood manganese levels (ug/dl) as affected by dietary manganese and fat.

Table VI. Mean Urinary Manganese Excretion (yg/day), Manganese Balance (mg/day) and Whole Blood Manganese (yg/dl) in Humans Fed Varying Levels of Manganese and Fat...

Various unrelated medical conditions have been observed to be associated with lowered serum or whole blood manganese. These include osteoporosis, diabetes mellitus, and epilepsy. The clinical relevance of such observations is uncertain. 

There is a necessity to balance the need for adequate manganese nutrition against the potential risk from toxicity. This necessitates monitoring of manganese status in at-risk patients. Whole blood manganese levels are not responsive to dietary depletion, but measurement of serum manganese,... 

Plastic cannulae should be used for phlebotomy, and hemolysis should be prevented during sample separation. Whole blood has about 10 times as much manganese as plasma or serum and is not as affected by contamination from steel needles during sample collection. This makes measurement of whole blood manganese the most widely used method in clinical laboratory practice for monitoring manganese status. 

Clegg MS, Lonnerdal B, Hurley LS, et al. 1986. Analysis of whole blood manganese by flameless atomic absorption spectrophotometry and its use as an indicator of manganese status in animals. Anal Biochem 157 12-18. 

Devenyi AG, Barron TF, Mamourian AC. 1994. Dystonia, hyperintense basal ganglia, and whole blood manganese levels in Alagille s syndrome. Gastroenterology 106 1068-1071. 

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