MANGANESE IN LONG-TERM PEDIATRIC PARENTERAL-NUTRITION

The current practice of providing manganese supplementation to neonate s on long term parenteral nutrition is leading to a high incidence of hypermanganesaemia. Magnetic resonance imaging (MRT) studies in adults on long term manganese parenteral nutrition have shown changes in TI weighted MRI images and similar findings in a neonate receiving trace element supplementation are reported here. Whole blood manganese conce ntration in the infant was 1740 nmol/l (or 8.3 times upper reference l imit). In all neonates on long term parenteral nutrition with evidence of cholestatic liver disease so far investigated, the whole blood man ganese concentrations were >360 nmol/l (reference range 73-210). Manga nese supplementation to patients on long term parenteral nutrition req uires reappraisal, particularly in those who develop cholestatic liver disease associated with parenteral nutrition.