Manganese (Mn)

Chemical Pathology

Notes

• The most frequent cause of a raised blood manganese level is contamination of the specimen when collecting blood. Measuring manganese in whole blood samples reduces this risk, although avoidance of stainless steel needles during collection is also helpful (use plastic cannula or discard first few mls of blood).
• Toxicity is not seen with slight elevations, but can occur in occupational exposure and chronic liver disease.
• Clinical disease due to manganese deficiency has not been convincingly demonstrated in humans, not even with prolonged total parenteral nutrition.
• Manganese additives are still included in TPN preparations but in lower amounts than previously. Children with liver problems on TPN can still accumulate manganese.
• Patients on home TPN should have manganese levels checked every 3 - 6 months to rule out excess accumulation (NICE Guideline CG32)
• Individuals with suspected toxicity due to occupational exposure should also have manganese levels checked.

Sample requirements

For adults, blood taken into a 4mL EDTA tube

For children, blood taken into a 2mL EDTA tube

Storage/transport

Do not store. Send at ambient temperature to the laboratory on the day of sample collection.

Required information

Relevant clinical details, including details of suspected exposure or any prolonged TPN.

Turnaround times

Samples are sent for to a referral laboratory for analysis with results expected back within 2 weeks.

Reference ranges

Less than 1 year old: 120 - 325 nmol/L

Greater than 1 year old: 73 - 210 nmol/L

• Unit conversion factor: µg/L x 18.2 nmol/L

Further information

To learn more about trace elements visit Lab Tests Online or access the NICE Guidelines CG32 Nutrition Support in Adults

Page last updated: 04/02/2019