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[Human selenium deficiency during total parenteral nutrition support (a case report)]
Summary
Selenium deficiency can occur in patients receiving long-term Total Parenteral Nutrition (TPN). Supplementation rapidly corrected low selenium levels and improved symptoms in a Chinese patient with gastrointestinal issues.
Area of Science:
- Clinical Nutrition
- Trace Elements
- Medical Case Study
Background:
- Selenium is vital for human nutrition, with deficiency increasingly reported in patients on long-term Total Parenteral Nutrition (TPN).
- This case represents the first reported instance of selenium deficiency in a TPN patient in China.
Observation:
- A patient with severe multiple gastrointestinal external fistulae and high fluid loss was admitted.
- The patient resided in an area known for low serum selenium levels.
- After two weeks of TPN, the patient exhibited low serum selenium levels (7.14-7.97 µg/L) and symptoms including elevated heart rate and thigh muscle pain.
Findings:
- TPN support for a patient with severe gastrointestinal issues led to critically low serum selenium levels.
- Selenium supplementation was initiated after four weeks.
- Following supplementation, serum selenium levels normalized, heart rate returned to normal, and muscle pain resolved.
Implications:
- This case highlights the risk of selenium deficiency in patients undergoing long-term TPN, especially those with significant gastrointestinal losses.
- Early monitoring and supplementation of selenium may be crucial for TPN patients to prevent deficiency-related complications.
- This underscores the importance of considering selenium status in nutritional support, particularly in at-risk populations and geographical areas.