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Test ID: MNU Manganese, 24 Hour, Urine

Reporting Name

Manganese, 24 Hr, U

Useful For

Monitoring manganese exposure in 24 hour urine collections

 

Nutritional monitoring

Clinical Information

Manganese (Mn) is a trace essential element with many industrial uses. Mining and iron and steel production have been implicated as occupational sources of exposure. It is principally used in steel production to improve hardness, stiffness, and strength. Mn is a normal constituent of air, soil, water, and food. The primary non-occupational source of exposure is by eating food or Mn-containing nutritional supplements. Vegetarians who consume foods rich in Mn such as grains, beans, and nuts, as well as, heavy tea drinkers may have a higher intake than the average person. People who smoke tobacco or inhale second-hand smoke are also exposed to Mn at higher levels than non-smokers.

 

Inhalation is the primary source of entry for Mn, but is also partially absorbed (3%-5%) through the gastrointestinal tract. Only very small amounts of Mn are absorbed dermally. Signs of toxicity may appear quickly, and neurological symptoms are rarely reversible. Mn toxicity is generally recognized to progress through 3 stages. Levy describes these stages. "The first stage is a prodrome of malaise, somnolence, apathy, emotional lability, sexual dysfunction, weakness, lethargy, anorexia, and headaches. If there is continued exposure, progression to a second stage may occur, with psychological disturbances, including impaired memory and judgement, anxiety, and sometimes psychotic manifestations such as hallucinations. The third stage consists of progressive bradykinesia, dysarthrian axial and extremity dystonia, paresis, gait disturbances, cogwheel rigidity, intention tremor, impaired coordination, and a mask-like face. Many of those affected may be permanently and completely disabled."(1) Mn is removed from the blood by the liver where it's conjugated with bile and excreted.

 

As listed in the United States National Agriculture Library, Mn adequate intake is 1.6 to 2.3 mg/day for adults. This level of intake is easily achieved without supplementation by a diverse diet including fruits and vegetables, which have higher amounts of manganese than other food types. Patients on a long-term parenteral nutrition should receive manganese supplementation and should be monitored to ensure that circulatory levels of manganese are appropriate.

Interpretation

Manganese (Mn) in urine represents the excretion of excess Mn from the body. Elevated levels may indicate occupational exposure or excessive nutritional intake.

 

Specimens from normal individuals have very low levels of Mn.

Analytic Time

1 day

Day(s) and Time(s) Performed

Thursday

Clinical Reference

1. Levy BS, Nassetta WJ: Neurologic effects of manganese in humans: A review. Int J Occup Environ Health Apr/Jun 2003;9(2):153-163

2. Paschal DC, Ting BG, Morrow JC, et al: Trace metals in urine of United States residents: Reference range concentrations. Environ Res 1998 Jan;76(1):53-59

Method Name

Dynamic Reaction Cell-Inductively Coupled Plasma-Mass Spectrometry (DRC-ICP-MS)

Specimen Type

Urine


Necessary Information


24-Hour volume is required.



Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic urine container with no metal cap or glued insert

Submission Container/Tube: Plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 10 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. Refrigerate specimen within 4 hours of completion of 24-hour collection.

3. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens in Special Instructions for multiple collections.


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  7 days

Reference Values

<4.0 mcg/specimen

Reference values have not been established for patients that are <18 years of age.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

83785

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MNU Manganese, 24 Hr, U 8203-2

 

Result ID Test Result Name Result LOINC Value
8080 Manganese, 24 Hr, U 8203-2
TM26 Collection Duration 13362-9
VL24 Urine Volume 3167-4

Urine Preservative Collection Options

Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.

Ambient

OK

Refrigerate

Preferred

Frozen

OK

50% Acetic Acid

No

Boric Acid

No

Diazolidinyl Urea

No

6M Hydrochloric Acid

No

6M Nitric Acid

No

Sodium Carbonate

No

Thymol

No

Toluene

No

Mayo Clinic Laboratories | Endocrinology Catalog Additional Information:

mml-diabetes-metabolic-nutrition