Increased blood manganese in cirrhotic patients: Relationship to pallidal magnetic resonance signal hyperintensity and neurological symptoms
| Autor: | Roger F. Butterworth, Suzanne Fontaine, L. Spahr, P C Milette, L Bui, Guy Therrien, A. LeBlanc, Gilles Pomier-Layrargues, Joseph Zayed, L H Lebrun |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Pathology Cirrhosis medicine.medical_treatment Neurological disorder Globus Pallidus Chronic liver disease Gastroenterology Liver disease Basal Ganglia Diseases Extrapyramidal symptoms Internal medicine medicine Humans Aged Manganese Hepatology medicine.diagnostic_test business.industry Manganese Poisoning Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Hyperintensity Female medicine.symptom business Transjugular intrahepatic portosystemic shunt |
| Zdroj: | Hepatology. 24:1116-1120 |
| ISSN: | 1527-3350 0270-9139 |
| DOI: | 10.1002/hep.510240523 |
| Popis: | Increasing evidence suggests that manganese deposition is responsible for the T1-weighted magnetic resonance imaging (MRI) signal hyperintensity consistently observed in pallidum of cirrhotic patients. However, the relationship between blood manganese and the etiology or severity of liver disease, as well as the neurological symptomatology in these patients, has not been well established. In the present study, blood manganese concentrations were measured by atomic absorption spectrometry together with MRI and neurological evaluation in 57 cirrhotic patients with various etiologies and severity of liver disease. Blood manganese concentrations were elevated in 67% of cirrhotic patients and were significantly higher in patients with previous portacaval anastomoses or transjugular intrahepatic portosystemic shunt (TIPS). Pallidal signal hyperintensity was observed in 88% of patients, and significant correlations were demonstrated between blood manganese and pallidal index (PI) (a measure of pallidal signal hyperintensity), as well as Child-Pugh score. Assessment of extrapyramidal symptoms using the Columbia rating scale revealed a significant incidence of tremor, rigidity, or akinesia in up to 89% of cirrhotic patients. However, there was no significant correlation between blood manganese and extrapyramidal symptoms, although severity of akinesia was significantly greater in Child-Pugh C patients. Extrapyramidal symptoms could result from a toxic effect of manganese on basal ganglia dopaminergic function. These findings further support a role for manganese in the etiology of pallidal MRI signal hyperintensity in patients with chronic liver disease. |
| Databáze: | OpenAIRE |
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