{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T17:51:20Z","timestamp":1760982680700,"version":"build-2065373602"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[1999,11,1]],"date-time":"1999-11-01T00:00:00Z","timestamp":941414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1999,11]]},"abstract":"<jats:p><jats:italic>Background:<\/jats:italic> Hypermanganesemia and cholestatic liver disease are both recognized complications of long\u2010term IV nutrition. Manganese is primarily excreted in bile, and recent studies have indicated that manganese toxicity may play a role in the pathogenesis of IV nutrition\u2010associated cholestasis. <jats:italic>Methods:<\/jats:italic> Whole blood and plasma manganese concentrations were measured in patients receiving long\u2010term home IV nutrition (HIN, n = 30). Whole blood manganese concentrations also were measured in patients with chronic liver disease (CLD, n = 10) and control subjects (n = 10). <jats:italic>Results:<\/jats:italic> Whole blood manganese concentrations of all CLD patients were within the reference interval (73 to 210 nmol\/L) and were not different from those of the control group (151 \u00b1 44 nmol\/L, CLD <jats:italic>vs<\/jats:italic> 155 \u00b1 35 nmol\/L, control; not significant), despite the presence of cholestasis. In contrast, whole blood manganese concentration was increased (&gt;210 nmol\/L) in 26 patients, and plasma manganese concentration increased (&gt;23 nmol\/L) in 23 of the patients receiving HIN. None of the patients exhibited neurologic signs of manganese toxicity. There was no correlation between whole blood manganese concentrations and markers of cholestasis, IV manganese intake, or duration of HIN. However, plasma manganese concentration correlated both with average weekly IV manganese intake (<jats:italic>r<\/jats:italic> =.44, <jats:italic>p<\/jats:italic> =.02) and with \u03b3\u2010glutamyl transferase (r =.43, p =.02) and alkaline phosphatase activities (<jats:italic>r<\/jats:italic> =.55, <jats:italic>p<\/jats:italic> =.003). <jats:italic>Conclusions:<\/jats:italic> Cholestatic liver disease does not appear to contribute to increased whole blood manganese concentrations in patients not receiving HIN. Plasma manganese concentrations in patients receiving HIN reflect recent manganese exposure and impaired excretion where cholestasis is present. The lack of relationship between plasma and whole blood manganese concentrations suggests that factors other than manganese intake and excretion affect intracellular concentrations. <jats:italic>(Journal of Parenteral and Enteral Nutrition<\/jats:italic> 23:350\u2013355, 1999)<\/jats:p>","DOI":"10.1177\/0148607199023006350","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"350-355","source":"Crossref","is-referenced-by-count":37,"title":["Hypermanganesemia in Long\u2010Term Intravenous Nutrition and Chronic Liver Disease"],"prefix":"10.1002","volume":"23","author":[{"given":"Catherine A.","family":"Wardle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alastair","family":"Forbes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman B.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.V.","family":"Jawhari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Shenkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1999,11]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1001\/jama.1979.03290450049024","article-title":"Department of Foods and Nutrition : Guidelines for essential trace element preparations for parenteral use","volume":"241","author":"American Medical Association","year":"1979","journal-title":"JAMA"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607184008003254"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1909445"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607195019004310"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.185.2.1410368"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)90109-G"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/014860719702100141"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.71.6.527"},{"key":"e_1_2_1_10_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1152\/ajplegacy.1966.211.1.211","article-title":"The role of the liver in regulating the distribution and excretion of manganese","volume":"211","author":"Papavasiliou PS","year":"1966","journal-title":"Am J Physiol"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92164-8"},{"key":"e_1_2_1_12_1","first-page":"409","article-title":"Acute manganese overload: A new experimental model of intrahepatic cholestasis","volume":"54","author":"Wizelben C.","year":"1968","journal-title":"Am J Pathol"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-2952(85)90435-6"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607189013002168"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)90735-7"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456329603300603"},{"key":"e_1_2_1_17_1","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1093\/jn\/119.10.1461","article-title":"Identification of transferrin as the major plasma carrier protein for manganese introduced orally or intravenously after in vitro addition in the rat","volume":"119","author":"Davidsson L.","year":"1989","journal-title":"J Nutr"},{"key":"e_1_2_1_18_1","first-page":"836","article-title":"Neutron activation analysis: The stability of manganese concentrations in human blood and serum","volume":"67","author":"Cotzias GC","year":"1966","journal-title":"J Lab Clin Med"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)90855-7"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.1_Part_1.65"},{"key":"e_1_2_1_21_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1152\/physrev.1958.38.3.503","article-title":"Manganese in health and disease","volume":"38","author":"Cotzias GS","year":"1958","journal-title":"Physiol Rev"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199708143370707"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(97)00334-1"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0148607199023006350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T10:04:40Z","timestamp":1760868280000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0148607199023006350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,11]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[1999,11]]}},"alternative-id":["10.1177\/0148607199023006350"],"URL":"https:\/\/doi.org\/10.1177\/0148607199023006350","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"type":"print","value":"0148-6071"},{"type":"electronic","value":"1941-2444"}],"subject":[],"published":{"date-parts":[[1999,11]]}}}