Hyperintense basal ganglia on MR imaging in hematopoietic stem cell transplantation recipient

Hiperintensidade nos gânglios da base em ressonância magnética do crânio em paciente pós-transplante de células tronco hematopoiética

IMAGES IN NEUROLOGY

Hyperintense basal ganglia on MR imaging in hematopoietic stem cell transplantation recipient

Hiperintensidade nos gânglios da base em ressonância magnética do crânio em paciente pós-transplante de células tronco hematopoiética

Plínio M.G. de Lima^I; Flávia Z. Piazera^II; Marco A. Bitencourt^II; Elenaide C. Nunes^II; Juliane Morando^II; Sérgio C. Fortier^II; Adriana Koliski^II; Ricardo Pasquini^II; Jorge Zavala^I; Hélio A.G. Teive^I

^INeurology of Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba PR, Brazil

^IIBone Marrow Transplantation Services of Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba PR, Brazil

Correspondence

A 13-year-old boy presented seizures on day +37 after allogenic hematopoietic stem cell transplantation (HSCT) for Fanconi anemia. After HSCT this patient had received total parental nutrition (TPN) for 21 days. Neurological examination was normal. A MRI of the brain (Figure A-B) showed symmetric areas of hyperintensity in the basal ganglia. Serum manganese (Mn) was 7.7 µg/L (reference value <3.3 µg/L).

Basal ganglia Mn deposition, associated to elevated blood Mn levels, has been described in children receiving long-term TPN^1-3.

Received 12 March 2011

Accepted 31 March 2011

References

• 1. Fell JM, Reynolds AP, Meadows N, et al. Manganese toxicity in children receiving long-term parenteral nutrition. Lancet 1996;347:1218-1221.
• 2. Quaghebeur G, Taylor WJ, Kingsley DPE. MRI in children receiving total parenteral nutrition. Neuroradiology 1996;38:680-683.
• 3. Kim Y. Neuroimaging in manganism. Neurotoxicology 2006;27:369-372.

Publication Dates

• Publication in this collection
  01 Sept 2011
• Date of issue
  Aug 2011