Aminosalicylic Acid Treats Manganese Intoxication

A recent study described the 17-year follow-up of a patient suffering from chronic manganese (Mn) intoxication, a syndrome resembling Parkinson's disease, who was successfully treated with aminosalicylic acid.

Aminosalicylic acid (also known as p-aminosalicylic acid or 5-aminosalicylic acid) is an antibiotic used to treat tuberculosis. In addition, it has been used for over forty years in the treatment of inflammatory bowel diseases, where it has shown greater potency in Crohn's Disease. It is thought to act via NF-kB (Nuclear Factor kappa B) inhibition and free radical scavenging.

Investigators at Purdue University (West Lafayette, IN, USA) evaluated a 67-year old female patient who had been treated for Mn intoxication 17 years previously after having been exposed to airborne Mn for 21 years (1963-1984). At the time of treatment the patient had palpitations, hand tremor, lower limb myalgia, hypermyotonia, and a distinct festinating gait.

The patient was treated with six grams of aminosalicylic acid per day through an intravenous drip infusion for four days and rested for three days as one therapeutic course. Fifteen such courses were carried out between March and June 1987. At the end of the treatment, her symptoms were significantly alleviated, and handwriting recovered to normal.

The current paper, published in the June 2006 issue of the Journal of Occupational Environmental Medicine, reported that in 2004 the patient demonstrated a general normal presentation in clinical, neurologic, brain magnetic resonance imaging, and handwriting examinations with a minor yet passable gait.

Senior author Dr. Wei Zheng, professor of public health at Purdue University, said, "When manganese builds up in toxic levels in the body, people suffer from ‘occupational manganese parkinsonism,' which causes symptoms similar to Parkinson's disease. Victims experience hand tremors, poor coordination, unsteady gait, and a mask-like inability to show facial expressions. The amazing thing is that this drug reverses Parkinson-type symptoms of manganese intoxication. We see remarkable improvement after treatment with this drug even 17 years later.”



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