{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:49:41Z","timestamp":1777884581393,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Technology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Objective: To review hypermanganesemia-induced toxicities in adult patients receiving parenteral nutrition (PN) therapy. Data Sources: A comprehensive literature review was conducted from June 2020 to May 2021 on PubMED, MEDLINE, Scopus, ProQuest, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science. Study Selection and Data Extraction: Keyword and Boolean phrase searches were conducted using the following terminology: \u201cmanganese\u201d OR \u201cmanganesemia\u201d OR \u201cmanganism\u201d or \u201chypermanganesemia\u201d AND \u201ctotal parenteral nutrition\u201d OR \u201cPN\u201d or \u201cparenteral nutrition\u201d AND \u201ctoxicity\u201d OR \u201caccumulation.\u201d Appropriate filters, including \u201chumans\u201d and \u201cEnglish\u201d and NOT \u201creviews,\u201d were utilized on all databases to improve search outcomes. Data Synthesis: A total of 4 reports detailing hypermanganesemia in 57 patient encounters were included in this review. Significant heterogeneity exists with regard to the duration of manganese supplementation and the dose of manganese. Toxicity associated with manganese was observed in as few as 15 days. The dose of manganese, though likely governed by content in commercially available products, may regularly exceed the recommendations of clinical guidelines and should be limited to 55 \u00b5g\/day. Select patients with underlying malignancy, those with significant and prolonged Vitamin D deficiency, or those who have acquired a SLC30A10 genetic mutation may be at an increased risk of developing manganese toxicity. Conclusions: Clinicians must be cognizant of the concentration of trace elements added to PN, as manganese, and perhaps other biometals, may accumulate when dosed above the recommended daily allowances.<\/jats:p>","DOI":"10.1177\/87551225211023686","type":"journal-article","created":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T04:47:36Z","timestamp":1627706856000},"page":"260-266","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Manganese Toxicity Associated With Total Parenteral Nutrition: A Review"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0321-5608","authenticated-orcid":false,"given":"Justin P.","family":"Reinert","sequence":"first","affiliation":[{"name":"Bon Secours Mercy Health St. Vincent Medical Center, Toledo, OH, USA"},{"name":"The University of Texas at Tyler, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laramie D.","family":"Forbes","sequence":"additional","affiliation":[{"name":"Bon Secours Mercy Health St. Vincent Medical Center, Toledo, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,7,31]]},"reference":[{"key":"bibr1-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.2009.06145.x"},{"key":"bibr2-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2007.03.001"},{"key":"bibr3-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/7580707"},{"key":"bibr4-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/128.2.368S"},{"key":"bibr5-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2012.01.017"},{"key":"bibr6-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/9484028"},{"key":"bibr7-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1097\/nen.0b013e31812503cf"},{"key":"bibr8-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1093\/toxsci\/60.2.242"},{"key":"bibr9-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1177\/0148607199023006333"},{"key":"bibr10-87551225211023686","doi-asserted-by":"publisher","DOI":"10.3390\/nu10111819"},{"key":"bibr11-87551225211023686","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18091989"},{"key":"bibr12-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0033057"},{"key":"bibr13-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1038\/srep41804"},{"key":"bibr14-87551225211023686","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1139"},{"key":"bibr15-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1093\/toxsci\/kfp124"},{"key":"bibr16-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1177\/0148607111420157"},{"key":"bibr17-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1177\/104028006s39"},{"key":"bibr18-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000181841.07090.f4"},{"key":"bibr19-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290450049024"},{"key":"bibr20-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1177\/0884533612446706"},{"key":"bibr21-87551225211023686","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115621863"},{"key":"bibr22-87551225211023686","unstructured":"Addamel N [package insert]. 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