title: Fulminant heart failure due to selenium deficiency cardiomyopathy (Keshan disease).
abstract: 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.
authors.affiliation: Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, Southbank, Australia.
authors.forename: Michael Philip
authors.initials: MP
authors.lastname: Burke
authors.forename: Kenneth
authors.initials: K
authors.lastname: Opeskin
mesh_terms: 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*
chemical_list: D012643:Selenium