Clinical features of selenium deficiency in infants receiving long-term nutritional support.
OBJECTIVE
Selenium deficiency is a known complication in patients requiring long-term nutritional support; however, the clinical features of selenium deficiency in infants have not been completely described. We describe the clinical features of selenium deficiency in infants.


METHODS
Six infants with selenium deficiency were studied retrospectively, with a focus on the period of nutritional support, the clinical symptoms, and the chronologic changes in serum selenium concentrations before and after the administration of selenite.


RESULTS
The onset of selenium deficiency in five patients occurred at <6 mo of age; selenium deficiency occurred in one patient 14 mo after birth. One patient received parenteral nutrition for 15 mo after birth; the other five patients primarily received an elemental diet for 2-6 mo. In all patients, growth retardation and alopecia with pseudoalbinism were the characteristic symptoms of selenium deficiency. At the time of diagnosis, the serum selenium level in four patients was <2.0 microg/dL and serum selenium levels in two patients were 3.2 and 3.3 microg/dL, respectively. The resolution of hair symptoms corresponded to the level of serum selenium after 1-2 mo and a rapid improvement in growth occurred in all patients after the administration of selenite.


CONCLUSIONS
The early clinical symptoms of selenium deficiency in infants include growth retardation and alopecia with pseudoalbinism, which are reversible if the patients are treated with adequate amounts of selenite. Clinicians who manage infants receiving long-term nutritional support, including an elemental diet, should be aware of the symptoms associated with selenium deficiency.
Masumoto
Kouji
K
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kmasu@pedsurg.med.kyushu-u.ac.jp
Nagata
Kouji
K
Higashi
Mayumi
M
Nakatsuji
Takanori
T
Uesugi
Toru
T
Takahashi
Yukiko
Y
Nishimoto
Yuko
Y
Kitajima
Junko
J
Hikino
Shunji
S
Hara
Toshiro
T
Nakashima
Kazue
K
Nakashima
Kazuhiro
K
Oishi
Ryozo
R
Taguchi
Tomoaki
T
D000505:Alopecia / Q000209:etiology / Q000473:pathology*; D005260:Female; D006128:Growth / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000209:etiology / Q000473:pathology*; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D012189:Retrospective Studies; D012643:Selenium / Q000097:blood / Q000172:deficiency / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome