Effective treatment of manganese-induced occupational Parkinsonism with p-aminosalicylic acid: a case of 17-year follow-up study.

Abstract

OBJECTIVE:

Chronic manganese (Mn) intoxication induces syndromes resembling Parkinson disease. The clinical intervention has largely been unsuccessful. We report a 17-year follow-up study of effective treatment of occupational Mn parkinsonism with sodium para-aminosalicylic acid (PAS).

METHODS:

The patient, female and aged 50 at the time of treatment, was exposed to airborne Mn for 21 years (1963-1984). The patient had palpitations, hand tremor, lower limb myalgia, hypermyotonia, and a distinct festinating gait. She received 6 g PAS per day through an intravenous drip infusion for 4 days and rested for 3 days as one therapeutic course. Fifteen such courses were carried out between March and June 1987.

RESULTS:

At the end of PAS treatment, her symptoms were significantly alleviated, and handwriting recovered to normal. Recent follow-up examination at age 67 years (in 2004) showed a general normal presentation in clinical, neurologic, brain magnetic resonance imaging, and handwriting examinations with a minor yet passable gait.

CONCLUSIONS:

This case study suggests that PAS appears to be an effective drug for treatment of severe chronic Mn poisoning with a promising prognosis.

• Authors: Yue-Ming Jiang, Xue-An Mo, Feng-Qi Du, Xue Fu, Xia-Yan Zhu, Hong-Yu Gao, Jin-Lan Xie, Feng-Ling Liao, Enrico Pira, Wei Zheng
• Journal: Journal of occupational and environmental medicine (J Occup Environ Med) Vol. 48 Issue 6 Pg. 644-9 (Jun 2006) ISSN: 1076-2752 [Print] United States
• PMID: 16766929 (Publication Type: Case Reports, Journal Article)

Chemical References

• Aminosalicylic Acid

Topics

• Aminosalicylic Acid (therapeutic use)
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Manganese Poisoning (complications)
• Middle Aged
• Occupational Diseases (chemically induced, drug therapy)
• Occupational Exposure
• Parkinsonian Disorders (chemically induced, drug therapy)