Finding a Cure: The Quest for New Manganism Treatments
Patients in the early stages of manganese poisoning or manganism may be exhausted, weak, depressed, and headachy. Some researchers believe that the disease is reversible at this point, provided the patient is no longer exposed to manganese. These early manganism symptoms look a lot like signs of other conditions. Therefore, if you are a welder with health problems, you should check with your doctor and explain about your manganese exposure. Once more serious signs of manganism appear, such as awkward gait and tremors, it may be too late to stop the progression of the disease. Removing the source of manganese may no longer be helpful.
Doctors have used edetate calcium disodium (EDTA) as a manganism treatment. EDTA is a chelating agent, which means it binds metals into stable cyclic compounds. This is thought to lower their toxic effects and enhance their excretion from the body. One 1957 study used EDTA, caramiphen hydrochloride (an anticonvulsant ), mephenesin (a muscle relaxant), and a vitamin C preparation to treat a miner with motor problems, hallucinations, and other signs of manganese poisoning. He recovered nicely (Arch Neurol. 2000 Apr; 57(4): 597–9; Arch Ind Health. 1957; 16:64–66).
In 1996, a Japanese researcher reported the case of a 55–year old woman with a moving tremor, unsteady gait, high manganese levels in her blood and urine, and an MRI scan consistent with a diagnosis of manganism. She responded well to EDTA, and an MRI scan after this manganism treatment showed a lessening of the brain pattern typical of manganism patients (Rinsho Shinkeigaku, 1996 Jun; 36(6): 780–2). An Italian study, again on only one patient, also showed the value of EDTA in manganism treatment (Neurotoxicology 2000 Oct; 21(5): 863–6).
Chinese researchers reported on two manganism patients who were given sodium para–aminosalicylic acid (PAS sodium), a drug used along with other medications to treat tuberculosis (Br J Ind Med. 1992 Jan; 49(1): 66–9). One manganism patient was considered cured and the other’s symptoms were lessened.
These studies are encouraging, but limited by the small number of patients treated and the lack of control groups. More work needs to be done to see if PAS sodium or EDTA are truly effective and safe manganism treatments. If they prove valuable, even more tests would be necessary to determine proper dosage and to deal with any side effects. Meanwhile, the best way to treat manganism is to recognize it early, before it becomes irreversible, and to remove the patient from the source of manganese exposure.