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Test Code MNCRU Manganese/Creatinine Ratio, Random, Urine

Reporting Name

Manganese/Creat Ratio, Random, U

Useful For

Monitoring manganese exposure

 

Nutritional monitoring

 

Clinical trials

Profile Information

Test ID Reporting Name Available Separately Always Performed
MNCR Manganese/Creat Ratio, U No Yes
CDCR Creatinine Conc No Yes

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Urine


Specimen Required


Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic, 10-mL urine tube (T068) or clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 3 mL

Collection Instructions:

1. Collect a random urine specimen.

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

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


Specimen Minimum Volume

0.8 mL

Specimen Stability Information

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

Reference Values

<4.0 mcg/g creatinine

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

Day(s) and Time(s) Performed

Tuesday, Friday; 8 a.m.

CPT Code Information

83785 Manganese Concentration

82570 Creatinine Concentration

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MNCRU Manganese/Creat Ratio, Random, U In Process

 

Result ID Test Result Name Result LOINC Value
CDCR Creatinine Conc 2161-8
32867 Manganese/Creat Ratio, U 27367-2

Clinical Information

Manganese (Mn) is an essential trace element with many industrial uses. Manganese is the 12th most abundant element in the earth's crust and is used predominantly in the production of steel. These industrial processes cause elevated environmental exposures to airborne manganese dust and fumes, which in turn have led to well-documented cases of neurotoxicity among exposed workers. Mining and iron and steel production have been implicated as sources of exposure.

 

Inhalation is the primary source of entry for manganese toxicity. Signs of toxicity may appear quickly or not at all; neurological symptoms are rarely reversible. Manganese 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 judgment, 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)

 

Few cases of manganese deficiency or toxicity due to ingestion have been documented. Only 1% to 3% manganese is absorbed via ingestion, while most of the remaining manganese is excreted in the feces. As listed in the United States National Agriculture Library, manganese 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.

Analytic Time

1 day

NY State Approved

Yes

Method Name

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

CDCR: Enzymatic Colorimetric Assay

Test Classification

See Individual Test IDs