Please use this identifier to cite or link to this item: https://doi.org/10.3390/ijerph15040783
Title: Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder
Authors: Ho, C.S.H
Ho, R.C.M 
Quek, A.M.L 
Keywords: azathioprine
entecavir
immunoglobulin
manganese
methylprednisolone
olanzapine
rivastigmine
valproic acid
voltage gated potassium channel
antibody
voltage gated potassium channel
antibody
encephalitis
heavy metal
manganese
near infrared
poisoning
potassium
toxicity
adult
Article
brain disease
case report
chronic hepatitis B
clinical article
clinical examination
cognitive defect
confusion
dementia
diaphoresis
disease association
drug substitution
drug withdrawal
dysphagia
dystonic disorder
echography
electroencephalogram
functional near-infrared spectroscopy
gallbladder disease
heavy metal blood level
heavy metal poisoning
human
hyperbilirubinemia
immunoassay
liver dysfunction
magnesium urine level
male
mental disease
muscle hypertonia
occupational exposure
paraneoplastic neuropathy
recurrent disease
stupor
urinalysis
cognitive defect
immunology
intoxication
middle aged
psychosis
Antibodies
Cognitive Dysfunction
Humans
Limbic Encephalitis
Male
Manganese Poisoning
Middle Aged
Potassium Channels, Voltage-Gated
Psychotic Disorders
Issue Date: 2018
Citation: Ho, C.S.H, Ho, R.C.M, Quek, A.M.L (2018). Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. International Journal of Environmental Research and Public Health 15 (4) : 783. ScholarBank@NUS Repository. https://doi.org/10.3390/ijerph15040783
Abstract: Heavy metal poisoning is a rare but important cause of encephalopathy. Manganese (Mn) toxicity is especially rare in the modern world, and clinicians’ lack of recognition of its neuropsychiatric manifestations can lead to misdiagnosis and mismanagement. We describe the case of a man who presented with recurrent episodes of confusion, psychosis, dystonic limb movement and cognitive impairment and was initially diagnosed with anti-voltage-gated potassium channel (VGKC) complex limbic encephalitis in view of previous positive autoantibodies. His failure to respond to immunotherapy prompted testing for heavy metal poisoning, which was positive for Mn. This is the first report to examine an association between Mn and VGKC antibodies and the effects of Mn on functional brain activity using functional near-infrared spectroscopy (fNIRS). © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
Source Title: International Journal of Environmental Research and Public Health
URI: https://scholarbank.nus.edu.sg/handle/10635/176207
ISSN: 1661-7827
DOI: 10.3390/ijerph15040783
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