Test Code MNS Manganese, Serum
Reporting Name
Manganese, SUseful For
Monitoring manganese exposure using serum specimens
Nutritional monitoring
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
SerumSpecimen Required
Patient Preparation: High concentrations of gadolinium, iodine, and barium are known to interfere with most metal tests. If gadolinium-, iodine, or barium-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Supplies: Metal Free Specimen Vial (T173)
Collection Container/Tube: Plain, royal blue-top Vacutainer plastic trace element blood collection tube
Submission Container/Tube: 7-mL Mayo metal-free, screw-capped, polypropylene vial
Specimen Volume: 0.3 mL
Collection Instructions:
1. Allow the specimen to clot for 30 minutes, and then centrifuge to separate serum from the cellular fraction. Serum must be removed from cellular fraction within 4 hours of collection. Avoid hemolysis.
2. Remove the stopper. Carefully pour specimen into a Mayo metal-free, polypropylene vial, while avoiding transfer of the cellular components of blood. Do not insert a pipet into the serum to accomplish transfer, and do not ream the specimen with a wooden stick to assist with serum transfer.
3. See Metals Analysis Specimen Collection and Transport for complete instructions.
Specimen Minimum Volume
0.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 28 days | METAL FREE |
Ambient | 28 days | METAL FREE | |
Frozen | 28 days | METAL FREE |
Special Instructions
Day(s) Performed
Tuesday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
83785
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
MNS | Manganese, S | 5683-8 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
8413 | Manganese, S | 5683-8 |
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 nonsmokers.
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, dysarthria 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 Mn than other food types. Patients on a long-term parenteral nutrition should receive Mn supplementation and should be monitored to ensure that circulatory levels of Mn are appropriate.
Cautions
Specimens collected from healthy, unexposed adults have extremely low levels of manganese (Mn). Because of the high environmental concentration of Mn, contamination is always a possibility when considering elevated results. Precautions must be taken to ensure the specimen is not contaminated. Metal-free serum collection procedures must be followed, and centrifuged serum must be aliquoted into an acid-washed Mayo metal-free vial.
Report Available
2 to 8 daysSpecimen Retention Time
14 daysReject Due To
Gross hemolysis | Reject |
Gross lipemia | OK |
Gross icterus | OK |
Method Name
Triple-Quadrupole Inductively Coupled Plasma-Mass Spectrometry (ICP-MS/MS)
Secondary ID
8413Royal Blue Top Trace Element Serum Tube: