Manganese

Manganese is an essential trace element that acts as a catalyst for several enzymes involved in carbohydrate, glycosaminoglycan, and cholesterol metabolism. Manganese superoxide dismutase is found in mitochondria and is responsible for the inactivation of superoxide radicals. Deficiency of manganese may manifest as dermatitis with reduced cholesterol levels in males, although manganese deficiency in clinical practice is rare. Manganese intoxication results in a neurotoxic syndrome known as manganism and is a complication of total parenteral nutrition in those patients with hepatobillary disease.

Whole blood is the sample of choice for the measurement of manganese although plasma manganese can also be measured. As manganese is present in the steel used to make cannulas, it is advisable to collect a blood sample for manganese after another sample has been taken, or to discard the first 5 millilitres of blood before collection for manganese measurement. Alternatively a plastic cannula can be used.