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Chronic enteral poisoning caused by potassium permanganate: a case report
Abstract:
To our knowledge, this is the first case report of a multiple, low dosage ingestion of manganese. A 66-year-old male patient is presented, who ingested 125 ml of a 8% solution of potassium permanganate (10 g) within 4 weeks. As early as 2 weeks after the beginning of poisoning, psychological alterations were noted. Neurological examination revealed disturbances of many subsystems of the CNS. Visually evoked potentials showed prolongation of the P2-latency, not reported in earlier publications. Levels for manganese were elevated in peripheral blood as well as in hair samples. Treatment with calcium trisodium pentetate decreased serum levels and increased urine excretion of manganese. Nine months after poisoning, the first signs of progressive Parkinson disease became evident. The time-course of neurological symptoms seems to depend on a critical dose of manganese.
Insights
This case report details a patient with manganese poisoning from repeated low-dose potassium permanganate ingestion. Symptoms included psychological changes, central nervous system disturbances, and Parkinsonism, highlighting manganese toxicity risks.
Area of Science:
- Neuroscience
- Toxicology
Background:
- Manganese is an essential trace element, but excessive exposure can lead to neurotoxicity.
- Potassium permanganate, a source of manganese, is used in various industrial and medical applications.
Observation:
- A 66-year-old male presented with symptoms after ingesting 10g of potassium permanganate over 4 weeks.
- Early psychological alterations and central nervous system (CNS) disturbances were observed.
- Elevated manganese levels were detected in blood and hair samples.
Findings:
- Prolongation of P2-latency in visually evoked potentials, a novel finding.
- Development of progressive Parkinsonism nine months post-ingestion.
- Treatment with calcium trisodium pentetate effectively reduced serum manganese levels and increased urinary excretion.
Implications:
- This case highlights the potential for chronic, low-dose manganese exposure to cause significant neurotoxicity.
- The findings suggest a critical dose threshold for manganese-induced neurological symptoms, including Parkinsonism.
- This report underscores the importance of monitoring manganese levels in cases of suspected chronic poisoning.