Acute selenium toxicity associated with a dietary supplement.
Acute selenium toxicity associated with a dietary supplement.
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DOI：
10.1001/archinternmed.2009.495
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发表时间：
2010-02-08
影响因子：
--
通讯作者：
Jones, Timothy F.
中科院分区：
文献类型：
--
作者：
MacFarquhar, Jennifer K.;Broussard, Danielle L.;Melstrom, Paul;Hutchinson, Richard;Wolkin, Amy;Martin, Colleen;Burk, Raymond F.;Dunn, John R.;Green, Alice L.;Hammond, Roberta;Schaffner, William;Jones, Timothy F.
Selenium is an element necessary for normal cellular function, but it can have toxic effects at high doses. We investigated an outbreak of acute selenium poisoning. A case was defined as the onset of symptoms of selenium toxicity in a person within 2 weeks after ingesting a dietary supplement manufactured by “Company A,” purchased after January 1, 2008. We conducted case finding, administered initial and 90-day follow-up questionnaires to affected persons, and obtained laboratory data where available. The source of the outbreak was identified as a liquid dietary supplement that contained 200 times the labeled concentration of selenium. Of 201 cases identified in 10 states, 1 person was hospitalized. The median estimated dose of selenium consumed was 41 749 μg/d (recommended dietary allowance is 55 μg/d). Frequently reported symptoms included diarrhea (78%), fatigue (75%), hair loss (72%), joint pain (70%), nail discoloration or brittleness (61%), and nausea (58%). Symptoms persisting 90 days or longer included fingernail discoloration and loss (52%), fatigue (35%), and hair loss (29%). The mean initial serum selenium concentration of 8 patients was 751 μg/L (reference range, ≤125 μg/L). The mean initial urine selenium concentration of 7 patients was 166 μg/24 h (reference range, ≤55 μg/24 h). Toxic concentrations of selenium in a liquid dietary supplement resulted in a widespread outbreak. Had the manufacturers been held to standards used in the pharmaceutical industry, it may have been prevented.
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