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Manganese toxicity in a child with iron deficiency and polycythemia

Paula Brna1, Kevin Gordon, Joseph M Dooley

  • 1Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada. pbrna@dal.ca

Journal of Child Neurology
|May 21, 2011
PubMed

Insights

A child developed manganism, a neurological disorder caused by manganese toxicity, presenting with gait issues and behavioral changes. Well water was identified as a potential exposure source, highlighting environmental risks.

Area of Science:

  • Neuroscience
  • Environmental Health
  • Pediatrics

Background:

  • Manganese is an essential trace element, but excessive exposure can lead to neurotoxicity.
  • Manganism is a neurological disorder mimicking Parkinson's disease, characterized by movement abnormalities.

Observation:

  • A previously healthy 5-year-old girl exhibited pica, emotional lability, and severe gait abnormalities.
  • Concurrent severe iron deficiency and polycythemia were noted.
  • MRI revealed basal ganglia T1 hyperintensities, suggesting manganese neurotoxicity.

Findings:

  • Elevated blood manganese levels confirmed manganism.
  • Chelation therapy partially improved mobility but gait impairment persisted.
  • An epidemiological study implicated well water as the likely source of manganese exposure.

Implications:

  • This case underscores the risk of environmental manganese exposure, particularly through contaminated water sources.
  • Further research is needed to understand individual susceptibility to manganese neurotoxicity.
  • Early identification and intervention are crucial for managing manganism in children.

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