Turnaround times
The quoted turnaround time is from sample receipt in the laboratory, to results authorisation in the Laboratory Information Management system. The times do not include transport of specimen to the laboratory or the administrative process to print and post/email reports. Service users must allow for transport and reporting time when ordering tests.
Clinical background:
Manganese is an essential trace element that acts as a catalyst for several enzymes involved in carbohydrate, glycosaminoglycan and cholesterol metabolism. Rich sources of manganese include whole grain cereals, vegetables, nuts, legumes, tea and coffee, and so human deficiency is extremely rare.Whole blood manganese is usually measured to assess potential toxicity, due to occupational exposure or patients receiving long-term total parenteral nutrition (TPN). Chronic manganese exposure results in manganese accumulation in the substantia nigra of the brain (visible by MRI scan), causing a Parkinsonian-like neurodegenerative disorder known as manganism. These brain and motor abnormalities are often irreversible even after the route of manganese exposure has been removed.It is recommended that whole blood manganese is measured to assess body status in chronic occupational exposure and those on long-term TPN. Manganese toxicity can be exacerbated if liver disease/cholestasis is present, and therefore it is recommended that manganese is not supplemented in TPN feeds in cholestatic patients.
Specimen container paediatric:
Navy blue top ‘trace element’ tube with purple-striped label – preferred sample if sufficient blood can be collectedPink top paediatric tube (EDTA anticoagulant)
Specimen container adult:
Navy blue top ‘trace element’ tube with purple-striped label (EDTA anticoagulant)Available on request from Blood Sciences reception at both Freeman and RVI sites
Minimum volume paediatric:
1 mL blood
Minimum volume adult:
1 mL blood
Sample stability:
Whole blood samples are stable at 2 to 4°C for up to 6 weeks or at -20°C indefinitely.
Transport requirements:
Ambient temperature.
Freq analysis:
Assay performed weekly.
Quality assurance:
Trace Element Quality Assurance Scheme (TEQAS) for Trace Elements
Interpretation:
Risk of toxicity: >360 nmol/L (if continued exposure)High risk of toxicity: >500 nmol/L
Reference ranges:
80 – 260 nmol/L
Referenced documents:
Aschner M., Vrana K.E., Zheng W. Manganese uptake and distribution in the central nervous system. Neurotoxicology 1999; 20: 173 to 180.Bertinet D.B., Tinivella M., Balzola F.A., et al.
Brain manganese deposition and blood levels in patients undergoing home parenteral nutrition. JPEN 2000; 24: 223-227.Hardy G.
Manganese in Parenteral Nutrition: Who, When, and Why Should We Supplement? Gastroenterol 2009; 137: S29-S35.O.Neal S.L., Zheng W.
Manganese toxicity upon overexposure: a decade in review. Curr Envir Health Rpt 2015; 2: 315-328.Spencer A.
Whole blood manganese levels in pregnancy and the neonate. Nutrition 1999; 15: 731-734.
Other info:
Assay performed by ICP-MS in standard mode.