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Two fatal cases of selenium toxicity.

Henry A Spiller¹, Eric Pfiefer

¹Kentucky Regional Poison Center, PO Box 35070, Louisville, KY 40232-5070, USA. henry.spiller@nortonhealthcare.org

Forensic Science International

|August 8, 2006

Summary

Selenium toxicity can be fatal, presenting with rapid onset gastrointestinal and cardiovascular collapse. Postmortem analysis, even in embalmed tissues, can detect elevated selenium levels, confirming it as a cause of death.

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Area of Science:

Toxicology
Forensic Pathology

Background:

Selenium is an essential trace element, but excessive intake can lead to toxicity.
Understanding the clinical and postmortem manifestations of acute selenium poisoning is crucial for diagnosis.

Observation:

Two patients presented with acute onset nausea, vomiting, diarrhea, abdominal pain, muscle weakness, and pallor.
Symptoms rapidly progressed to refractory hypotension, pulmonary edema, and cardiovascular collapse within 14-16 hours.
Autopsies revealed hemorrhagic pulmonary edema and splenomegaly without an obvious anatomical cause of death.

Findings:

Postmortem analysis, including in exhumed and embalmed tissue, detected elevated selenium concentrations.
This confirmed selenium poisoning as the cause of death in both cases.
Key findings include selenium's potential as a homicidal agent, a defined toxidrome and timeframe, and methods for selenium determination in challenging postmortem samples.

Implications:

Highlights the importance of considering selenium toxicity in unexplained sudden deaths with compatible symptoms.
Demonstrates the utility of postmortem selenium analysis, even in challenging cases.
Provides critical data on the temporal dynamics of selenium levels in tissues postmortem.

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