Test Category: Specialist Biochemistry
Investigation Name:Manganese- urine
Alias or Abbreviation:Urine Mn, 24 hour urine manganese excretion, urine manganese to creatinine ratio
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.Deficiency is rare in clinical practice as manganese is present in many foods. Conversely, manganese toxicity, also known as ‘manganism’ is much more common. Excess levels can accumulate in the basal ganglia, particularly in patients on long term total parenteral nutrition (TPN), where the manganese may be a supplement or contaminant of the TPN formulation.
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.
Manganese is also used in alloy production, mining, welding and for the colouring of ceramics and glass. Therefore, manganism may also arise due to occupational exposure. Toxicity is largely evident as behavioural changes and Parkinson’s disease-like motor symptoms, and is usually quantified by measurement of manganese in urine. Whole body manganese status is best determined by blood manganese.
Pathology Laboratory:Trace Elements Laboratory
Requestable Seperately?Yes
Units:nmol/24 hr (24 hour urine collection)
nmol/mmol creatinine (spot urine)
Minimum Sample Volume: 2 mL urine
Expected Turnaround Time:7 working days.
Urgent analysis where clinically indicated may be arranged directly with the laboratory.
Test Code:24MN (24 hour urine collection)
UMN (random urine)
Sample Type:
For monitoring 24hr manganese excretion:24h urine collection in polypropylene collection container or polyethylene container.
Specimens can be aliquoted into a plain white -top universal container prior to transportation.
24-hour collection period dates, time and total volume MUST be recorded.
Investigation of toxicity & occupational monitoring:
Spot urine collected into a plain white -top universal container. Urine samples collected from Papier-maché bottles or catheter bags are NOT suitable.
Complex Reference Range:24 hour urine manganese:
Less than 50 nmol/24 hr
Random (spot) urine manganese to creatinine ratio:
Manganese creatinine ratio: Less than 5.0 nmol/mmol creatinine
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,
Pathology Department,
Specialist chemistry,
Lyndon,
B71 4HJ
NPEX / PDF Reporting Available:Yes
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:Tel: 0121 507 5162
