Case Report: A Metabolic Disorder Presenting as Pediatric Manganism
| Autor: | Nadine Hamm, Scott Giffin, Linda Panaro, Mark Allen, Yves Léger, Vanita Sahni, Diane Fury |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Pathology
medicine.medical_specialty Erythrocytes Time Factors Health Toxicology and Mutagenesis water Physiology Environmental Medicine Metabolic Diseases medicine Manganism High doses Humans Manganese Poisoning Child Environmental medicine Manganese business.industry Research Dietary intake Metabolic disorder Public Health Environmental and Occupational Health Trace element toxicity medicine.disease Ferritins Toxicity Female business |
| Zdroj: | Environmental Health Perspectives |
| ISSN: | 1552-9924 0091-6765 |
| Popis: | Context Manganese is a trace element, essential for physiologic functioning but neurotoxic at high doses. Common exposure sources include dietary intake as well as drinking water in some regions; toxicity is most often associated with inhalation exposures in occupational settings. In this article we describe the investigation of a pediatric case of manganism using both clinical and environmental assessment methods. Case presentation A previously healthy 6-year-old child presented with severe Mn neurotoxicity, iron deficiency, and elevated cobalt levels. Immediate and selected extended family members had elevated plasma Mn but remained asymptomatic. An exposure assessment identified seasonal ingestion exposures to Mn at the family’s summer cottage; these were common to the four immediate family members. Well water used for drinking and cooking exceeded recommended guidelines, and foods high in Mn predominated in their diet. No inhalation exposures were identified. Only pica was unique to the patient. Discussion The combined evidence of the environmental assessment and biomonitoring of blood Mn levels supported a seasonal ingestion exposure source; this alone was insufficient to explain the toxicity because the patient’s 7-year-old sibling was asymptomatic with almost identical exposures (except pica). A metabolic disorder involving divalent metals (Mn, Fe, and Co) interacting with environmental exposures is the most likely explanation. Relevance to clinical or professional practice This case report adds to the emerging body of evidence linking neurologic effects to ingestion Mn exposure. |
| Databáze: | OpenAIRE |
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