Manganese Toxicity in a Child With Iron Deficiency and Polycythemia

A previously healthy 5-year-old girl presented with pica, emotional lability, and marked gait abnormalities. She had concurrent severe iron deficiency and polycythemia. Her magnetic resonance imaging (MRI) scan showed increased signal in the basal ganglia on T1-weighted images consistent with mangan...

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Bibliographic Details
Published in:Journal of child neurology 2011-07, Vol.26 (7), p.891-894
Main Authors: Brna, Paula, Gordon, Kevin, Dooley, Joseph M., Price, Victoria
Format: Article
Language:English
Subjects:
Anemia, Iron-Deficiency - complications
Anemia, Iron-Deficiency - drug therapy
Chelation Therapy
Child, Preschool
Female
Gait Disorders, Neurologic - chemically induced
Gait Disorders, Neurologic - drug therapy
Humans
Magnetic Resonance Imaging
Manganese Poisoning - complications
Manganese Poisoning - drug therapy
Manganese Poisoning - pathology
Polycythemia - complications
Polycythemia - drug therapy
Treatment Outcome
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Summary:A previously healthy 5-year-old girl presented with pica, emotional lability, and marked gait abnormalities. She had concurrent severe iron deficiency and polycythemia. Her magnetic resonance imaging (MRI) scan showed increased signal in the basal ganglia on T1-weighted images consistent with manganese neurotoxicity. Manganism was subsequently confirmed as her blood manganese levels were extremely elevated. Chelation therapy resulted in improvement in her mobility but she continues to have significant gait impairment. An epidemiological investigation identified well water as the potential source of manganese exposure for our patient, but to date, we have been unable to identify the nature of her neurotoxic susceptibility.
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073810393962