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Evaluating selenium poisoning.

Kern L Nuttall1

  • 1Laboratory Medicine, Bellingham, WA 98229, USA. kern_nuttall@yahoo.com

Annals of Clinical and Laboratory Science
|November 28, 2006
PubMed
Summary

Clinical laboratories face challenges in diagnosing selenium poisoning. Interpreting serum selenium levels requires considering patient symptoms, as total concentration doesn't always indicate toxicity.

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Area of Science:

  • Clinical Chemistry
  • Toxicology
  • Trace Element Analysis

Background:

  • Selenium poisoning evaluation presents diagnostic challenges for clinical laboratories.
  • Distinguishing toxic from non-toxic selenium elevations is complex due to varying toxic potentials of different selenium forms.
  • Total selenium concentration measurements can be misleading without considering chemical speciation.

Purpose of the Study:

  • To review selenium poisoning from a clinical laboratory perspective.
  • To highlight the difficulties in interpreting serum and tissue selenium levels.
  • To provide context for understanding selenium toxicity ranges.

Main Methods:

  • Review of published reports on human selenium poisoning.
  • Analysis of serum and blood selenium concentration ranges associated with acute and chronic toxicity.
  • Examination of postmortem blood selenium levels in fatal cases.
  • Evaluation of tissue selenium levels and their correlation with toxicity.

Main Results:

  • Serum selenium concentrations range from <1400 micro g/L (non-toxic) to 400-30,000 micro g/L (acute toxicity) and 500-1400 micro g/L (chronic toxicity).
  • Acute poisoning often involves inorganic selenium compounds like selenious acid.
  • Postmortem blood selenium levels >1400 micro g/L are linked to early fatalities.
  • Elevated tissue selenium, particularly in the kidney, does not always signify toxicity.

Conclusions:

  • Interpreting selenium levels requires integrating analytical data with clinical signs and symptoms.
  • The chemical form of selenium significantly influences its toxic potential.
  • Understanding the clinical significance of measured selenium concentrations remains a challenge in laboratory diagnostics.

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