{"id":"10ae13a5-06fb-51e0-87ea-022f03fe0873","stable_key":"be889add-cec8-500b-be89-676431432a70:mn-clin-iron-chelation-combination","predicate":"reduced","statement":"After more frequent chelation and added ferrous fumarate, blood manganese, MRI and liver findings improved; later iron dosing was reduced after serum iron rose excessively.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"negative","is_public":true,"mechanism_event_id":"15d0c977-5bbe-5cf8-9df4-c701e17f082e","mechanism_event_label":"The combined regimen affected both manganese removal and iron status.","subject":{"id":"d8cf9991-0714-5fc7-a58b-3ac9e81f896b","slug":"manganese-chelation-iron-combination","display_name":"Manganese chelation with added oral iron","entity_type_key":"cellular_process"},"object":{"id":"0ab0ec3e-0514-5159-a033-3cbf16d146f7","slug":"whole-blood-manganese-concentration","display_name":"Whole-blood manganese concentration","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"15d0c977-5bbe-5cf8-9df4-c701e17f082e","stable_key":"be889add-cec8-500b-be89-676431432a70:mn-clin-iron-chelation-combination-event","event_type":"observed_intervention","label":"The combined regimen affected both manganese removal and iron status.","description":"After more frequent chelation and added ferrous fumarate, blood manganese, MRI and liver findings improved; later iron dosing was reduced after serum iron rose excessively.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"bcb410c6-14b0-5384-b1bf-8e73b3dec4fe","slug":"ferrous-fumarate","display_name":"Ferrous fumarate","entity_type_key":"chemical_species"},"role":"added_treatment","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"711686eb-bcb3-5671-9ae3-ecce509d4b4c","slug":"calcium-disodium-edetate","display_name":"Calcium disodium edetate","entity_type_key":"chemical_species"},"role":"concurrent_treatment","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"89bcaf42-b4ab-5760-8c2e-44eace10cee0","slug":"iron","display_name":"Iron","entity_type_key":"nutrient_element"},"role":"interacting_nutrient","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"f0459455-8231-513b-8214-7ea5b3259b4b","slug":"manganese","display_name":"Manganese","entity_type_key":"nutrient_element"},"role":"affected_nutrient","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""},{"entity":{"id":"d8cf9991-0714-5fc7-a58b-3ac9e81f896b","slug":"manganese-chelation-iron-combination","display_name":"Manganese chelation with added oral iron","entity_type_key":"cellular_process"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":4,"notes":""},{"entity":{"id":"0ab0ec3e-0514-5159-a033-3cbf16d146f7","slug":"whole-blood-manganese-concentration","display_name":"Whole-blood manganese concentration","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":5,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"machinery_impairment","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"cross_nutrient","value_text":"Ferrous fumarate (added_treatment); Calcium disodium edetate (concurrent_treatment); Iron (interacting_nutrient); Manganese (affected_nutrient)","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/manganese-clinical-sources/stamelou2012.txt\", \"locator\": \"Clinical description; age 15–16 treatment changes\", \"file_sha256\": \"5d86a26fe564508fb382d1c8df61f531bfbaf06b69e2078b0999e3a3129555f6\", \"start_char\": 9842, \"end_char\": 10521, \"text_sha256\": \"2da91cbaa297984ac1c90caf8701ce0a3f9a633b806ef4fff178b6ecc46c8aa1\", \"text_characters\": 679}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Ten-year longitudinal report of one SLC30A10 patient","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Calcium disodium edetate chelation; subsequent increase in chelation frequency and addition of oral ferrous fumarate.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Repeated observations in one previously described patient. 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Combined treatment changes prevent attribution of later benefit to iron alone; disease-specific treatment is not routine nutrient replacement.\nexposure: Calcium disodium edetate chelation; subsequent increase in chelation frequency and addition of oral ferrous fumarate.\ncross_nutrient: Ferrous fumarate (added_treatment); Calcium disodium edetate (concurrent_treatment); Iron (interacting_nutrient); Manganese (affected_nutrient)\nevidence_span: {\"source_cache\": \"artifacts/manganese-clinical-sources/stamelou2012.txt\", \"locator\": \"Clinical description; age 15–16 treatment changes\", \"file_sha256\": \"5d86a26fe564508fb382d1c8df61f531bfbaf06b69e2078b0999e3a3129555f6\", \"start_char\": 9842, \"end_char\": 10521, \"text_sha256\": \"2da91cbaa297984ac1c90caf8701ce0a3f9a633b806ef4fff178b6ecc46c8aa1\", \"text_characters\": 679}\n[mn-clin-stamelou2012] Dystonia with brain manganese accumulation resulting from SLC30A10 mutations: a new treatable disorder. 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