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Selenium deficiency: report of a case
T Kanekura1, S Yotsumoto, N Maeno
1Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan. takurok@m2.kufm.kagoshima-u.ac.jp
Insights
Selenium deficiency in an infant caused severe skin issues and cardiomyopathy. Supplementation with sodium selenite effectively treated the skin symptoms, highlighting the importance of this trace element.
Area of Science:
- Pediatric Dermatology
- Nutritional Science
- Trace Element Metabolism
Background:
- Parenteral nutrition (PN) can lead to micronutrient deficiencies.
- Selenium is an essential trace element crucial for various physiological functions.
- Juvenile polyposis necessitated long-term PN in this pediatric patient.
Observation:
- An 18-month-old Japanese boy presented with characteristic skin findings: dry, erythematous changes, erosions, and sparse, light-colored hair.
- Serum selenium levels were critically low (<2.0 microg/dL) during PN.
- The patient also exhibited cardiomyopathy, a known complication of selenium deficiency.
Findings:
- Skin lesions showed significant improvement with sodium selenite supplementation.
- Clinical presentation mimicked zinc deficiency, emphasizing the diagnostic challenge of trace element imbalances.
- Diagnosis of selenium deficiency was supported by clinical signs, low serum levels, and literature review.
Implications:
- This case underscores the risk of selenium deficiency in patients on long-term PN.
- Early recognition and management of selenium deficiency are vital to prevent severe dermatological and cardiac complications.
- Highlights the importance of monitoring trace element status in pediatric patients receiving specialized nutrition support.
Abstract:
We report an 18-month-old Japanese boy with selenium deficiency. He had dry skin with irregularly shaped, erythematous changes on the cheeks, groin, hip, and extremities, erosions on the external urethral and anal orifices, and sparse, short, thin, light-coloured hair. He had received parenteral nutrition for 5 months because of juvenile polyposis. At presentation, his serum selenium level was less than 2.0 microg/dL (normal range, 10.6-17.4 microg/dL). His skin lesions responded well to supplementary treatment with sodium selenite. His skin symptoms were similar to those attributable to a deficiency of zinc which, like selenium, is an essential trace element. According to the literature, selenium deficiency is responsible for cardiomyopathy, which was diagnosed in our patient. The clinical similarity to zinc deficiency and the literature yielded important clues for a diagnosis of selenium deficiency in this patient.
