Chronic Manganese Neuro-Toxicity in a Patient With Cirrhosis and the Role of Iron-Deficiency Anaemia DOI Open Access

Jamal Jamal,

Muhammad Awais Hashmat,

Heba Alwan

et al.

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 6, 2024

Patients with chronic liver disease (CLD) are prone to complications associated impaired functioning. This coupled iron-deficiency anaemia (IDA) can predispose them multiple comorbidities. We present an interesting case of a 69-year-old woman background history cirrhosis due metabolic dysfunction-associated steatotic (MASLD) frequent travels Bangladesh, southeast Asian country known for having high levels manganese (Mn) in water domestic use. She presented progressively worsening cognition and extrapyramidal symptoms. underwent routine blood tests including functions followed by non-contrast computed tomogram (CT) the head that did not suggest possible cause. However, magnetic resonance imaging (MRI) brain showed hyperintensities bilaterally globus pallidus, subthalamic nucleus, red substantia nigra raised possibility Mn toxicity. was confirmed repeated Mn. The query acute toxicity Mn, consideration CLD reduced elimination complicated further her IDA. Her discussed multi-disciplinary setting specialities radiology, gastroenterology, neurology, psychiatry, hepatology, elderly medicine. Following this, decision made best supportive management patient. highlights importance MRI detection rare toxicity, predisposed individual contributing cognitive decline

Language: Английский

Chronic Manganese Neuro-Toxicity in a Patient With Cirrhosis and the Role of Iron-Deficiency Anaemia DOI Open Access

Jamal Jamal,

Muhammad Awais Hashmat,

Heba Alwan

et al.

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 6, 2024

Patients with chronic liver disease (CLD) are prone to complications associated impaired functioning. This coupled iron-deficiency anaemia (IDA) can predispose them multiple comorbidities. We present an interesting case of a 69-year-old woman background history cirrhosis due metabolic dysfunction-associated steatotic (MASLD) frequent travels Bangladesh, southeast Asian country known for having high levels manganese (Mn) in water domestic use. She presented progressively worsening cognition and extrapyramidal symptoms. underwent routine blood tests including functions followed by non-contrast computed tomogram (CT) the head that did not suggest possible cause. However, magnetic resonance imaging (MRI) brain showed hyperintensities bilaterally globus pallidus, subthalamic nucleus, red substantia nigra raised possibility Mn toxicity. was confirmed repeated Mn. The query acute toxicity Mn, consideration CLD reduced elimination complicated further her IDA. Her discussed multi-disciplinary setting specialities radiology, gastroenterology, neurology, psychiatry, hepatology, elderly medicine. Following this, decision made best supportive management patient. highlights importance MRI detection rare toxicity, predisposed individual contributing cognitive decline

Language: Английский

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