Yale New Haven Hospital

Department of Laboratory Medicine
Test Directory

[ Test Name Index ]

[ Home & References ]


Lab Section: 

Sendout Reference


Lab Location: 


Reference Lab: 



Test ID: 




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


Tuesday, Friday (a.m)


10 days

Specimen Requirements: 

Collection: 5.0 mL Blood in a Royal Blue Top - Serum.
Pediatric volume: 1 mL.
Plain, royal blue-top Monoject trace element blood collection tube(s)
Transport: Refrigerated.
Unacceptable conditions: Specimens other than serum; Hemolysis; Gross icteric
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 7 days



Clinical Indications: Manganese (Mn) is a trace essential element with many industrial uses. The twelfth most abundant element in the earth's crust, nearly all mined manganese is consumed in the production of ferromanganese, which is then used to remove oxygen and sulfur impurities from 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, and 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 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) 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.

Reference Interval: 

See patient report or consult reference laboratory website.


CPT Code(s): 


Last Changed: 

9/12/2017 2:12:46

Last Reviewed: 

9/12/2017 2:12:55