Fulminant heart failure due to selenium deficiency cardiomyopathy (Keshan disease).
Selenium deficiency is a rare cause of cardiomyopathy that may be encountered by the forensic pathologist. Selenium deficiency is associated with a cardiomyopathy, myopathy and osteoarthropathy. In Asia and Africa, dietary selenium deficiency is associated with a cardiomyopathy known as Keshan disease and an osteoarthropathy called Kashin-Beck disease. Chronic selenium deficiency may also occur in individuals with malabsorption and long term selenium-deficient parenteral nutrition. Selenium deficiency causes myopathy as a result of the depletion of selenium-associated enzymes which protect cell membranes from damage by free radicals. We present a case of fulminant heart failure in a middle aged woman with a complex medical and surgical history including documented malabsorption and selenium deficiency. Pathological examination of the heart showed features consistent with Keshan disease.
Burke
Michael Philip
MP
Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, Southbank, Australia.
Opeskin
Kenneth
K
D000328:Adult; D001344:Autopsy; D009202:Cardiomyopathies / Q000209:etiology* / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008286:Malabsorption Syndromes / Q000473:pathology; D012643:Selenium / Q000172:deficiency*
D012643:Selenium