Test Category: Specialist Biochemistry
Investigation Name:Manganese – Blood
Alias or Abbreviation:Mn
Accreditation:UKAS Accredited ISO15189:2022 On scope
Intro:
Manganese is an essential trace element that serves as a catalyst for several enzymes including hydrolases, kinases, decarboxylases and transferases. It is also required for the activity of metalloenzymes: arginase, pyruvate carboxylase and mitochondrial superoxide dismutase.As manganese is present in many foods, manganese deficiency is very rare in clinical practice. Furthermore, although patients on long term parenteral nutrition require manganese replacement, feeds often contain manganese concentrations in excess of requirements. Therefore, blood manganese testing is very rarely performed to detect manganese deficiency.
In healthy individuals, the body is protected against manganese toxicity by low gastrointestinal absorption and/or rapid pre-systemic elimination by the liver. Parenteral nutrition bypasses the homeostatic mechanism regulating manganese absorption and therefore, patients on long term parenteral nutrition are at risk of accumulating manganese, which can be exacerbated in the presence of cholestasis. Regular monitoring (every 3 to 6 months) of blood manganese is recommended by NICE Guidelines 2006 “Nutrition support for adults” in this group.
Pathology Laboratory:Trace Metals Laboratory
Requestable Seperately?No
Minimum Sample Volume:150 µL whole blood
Expected Turnaround Time:7 working days.
Urgent analysis where clinically indicated may be arranged directly with the laboratory.
Sample Type:
Preferred: Trace element free EDTA or sodium heparin whole blood Accepted: EDTA whole blood, where the tube lot has been tested to confirm that it is manganese-freeComplex Reference Range:Children <1 year, children > 1 year and adults 73-210 nmol/L
Risk of toxicity >360 nmol/L
Collection Conditions / Other Information:Blood samples are prone to contamination if taken via stainless steel needles, hence, a plastic canula should be used or the first few mLs of blood should be discarded.
Some types of EDTA tubes are contaminated with manganese. Please contact the laboratory to discuss tube contamination testing, where required
Referred to Another Laboratory?No
Storage Requirements:Store at 4 °C prior to dispatch
Posting Address / Requirements:Ambient temperature. 1st Class post.
Sandwell Health Campus,
Specialist Chemistry,
Pathology Department,
Lyndon,
B71 4HJ
EQA Scheme:UK NEQAS for Trace Elements
Further information:We are a designated Supra-Regional Assay Service (SAS) Laboratory for Trace Elements.
Lead Contact Details:Dr Nicola Barlow, Consultant Clinical Scientist,
SAS Director Trace Elements Laboratory
Email: nicola.barlow1@nhs.net
Email Address For Chasing Results:rwh-tr.bcpsspecialistchemistryenquiries@nhs.net
Methodology:Inductively coupled plasma mass spectrometry
Site Sample Tested:Sandwell Health Campus
Cost:Please email: bcpspathology.info@nhs.net for further details
Contact Number:0121 507 5162
