9778. Manganese (serum)

Determination of manganese concentration in serum is used for the diagnosis of acute and chronic manganese poisoning, confirmation of cases of occupational disease, and assessment of the balance of this trace element in the body.

Manganese (Mn) is an essential trace element for the body and is actively involved in biological processes. The daily requirement for manganese is several milligrams. Insufficient intake of manganese into the body causes slowed growth and development, anemia, lactational tetany, and impaired mineral metabolism of bone tissue. Mn is a normal component of air, soil, water, and food products. Vegetarians (due to the consumption of large amounts of foods rich in Mn, such as cereals, legumes, and nuts), people who consume a lot of tea, smoke tobacco, and inhale smoke during passive smoking may have higher levels of this trace element. Manganese is widely used in the mining industry and in the production of cast iron and steel (it provides high strength and significant elasticity). At high concentrations, it is toxic; therefore, in all industries where it is used, as well as during its extraction from ores, there is a potential risk of intoxication.

Acute manganese poisoning is rare. In occupational settings, chronic intoxication is of practical importance. The mining industry and the production of cast iron and steel are considered the main sources of manganese intoxication. Manganese enters the body through the respiratory tract, to a lesser extent through the gastrointestinal tract (3-5%) and the skin. It is slowly eliminated from the body through the digestive tract in the feces; to a lesser extent, it is excreted by the kidneys in the urine, with saliva, and in breast milk during lactation. It has a cumulative effect and is deposited in parenchymal organs, bones, endocrine glands, and the brain and spinal cord. The symptoms of chronic manganese intoxication develop gradually; three stages are distinguished in the clinical presentation. Stage I is characterized by functional changes in the central nervous system in the form of asthenovegetative syndrome. This stage is characterized by symptoms such as drowsiness, apathy, emotional lability, weakness, lethargy, loss of appetite, sexual dysfunction, and headache. Stages II and III of intoxication are characterized by neurological and psychiatric manifestations. Stage III is characterized by specific damage to the striopallidal system – manganese parkinsonism. Patients receiving long-term parenteral nutrition should receive Mn supplementation. A serum manganese level above the reference values may indicate recent exposure to this trace element.

• For workers at industrial enterprises where there is a high risk of manganese exposure (mining industry, production of steel and alloys, welding, production of batteries, ferroalloys, and certain chemicals).
• For patients with suspected acute or chronic manganese poisoning in the presence of corresponding symptoms (neurological disorders, parkinsonism, muscle weakness, mood changes, psychotic symptoms).
• For individuals who are receiving parenteral nutrition for a long period of time, as some solutions may contain elevated levels of manganese.
• Rarely – in cases of suspected manganese deficiency, which may manifest as impaired growth, skeletal abnormalities, and changes in glucose and lipid metabolism (although deficiency occurs extremely rarely).

• Venous blood

In order to exclude factors that may affect the test results, we recommend to follow the preparation rules: