Which trace elements may become elevated in cholestasis in PN patients?

Which trace elements may become elevated in cholestasis in PN patients?

• A. Zinc and Selenium
• B. Manganese and Copper
• C. Iron and Zinc
• D. Copper and Zinc

Answer: (B)

Cholestasis reduces the body’s ability to excrete certain trace elements that rely on bile for elimination. In patients receiving parenteral nutrition, copper and manganese are excreted via bile, so impaired bile flow leads to their accumulation. This makes manganese and copper the elements most likely to be elevated in cholestasis. Elevated manganese can cause neurotoxicity with deposition in the brain, while excess copper can contribute to hepatic injury. Zinc and selenium are not typically elevated in this situation and may even be deficient if PN balance isn’t optimal. Iron pairing with zinc isn’t a characteristic pattern for cholestasis-related elevations. Therefore, manganese and copper best fit the scenario.

Cholestasis reduces the body’s ability to excrete certain trace elements that rely on bile for elimination. In patients receiving parenteral nutrition, copper and manganese are excreted via bile, so impaired bile flow leads to their accumulation. This makes manganese and copper the elements most likely to be elevated in cholestasis. Elevated manganese can cause neurotoxicity with deposition in the brain, while excess copper can contribute to hepatic injury. Zinc and selenium are not typically elevated in this situation and may even be deficient if PN balance isn’t optimal. Iron pairing with zinc isn’t a characteristic pattern for cholestasis-related elevations. Therefore, manganese and copper best fit the scenario.