title: Selenium deficiency in children and adolescents nourished by parenteral nutrition and/or selenium-deficient enteral formula.
abstract: The authors analyzed serum selenium levels of 95 children and adolescents with intestinal dysfunction and/or neurological disabilities [age range: 7 months-20 years; mean±standard deviation (SD): 8.0±5.3 years] who received parenteral nutrition (PN) and/or enteral nutrition (EN) with either reduced or no selenium doses for more than 3 months. Twenty-eight patients (29%) showed serum selenium levels below 4.0μg/dL. Five patients whose serum selenium levels were below 2μg/dL presented various clinical manifestations, including hair browning (n=5), macrocythemia (n=4), nail whitening (n=3) and cardiac dysfunction (n=1). None of these 5 patients were nourished through ordinary diets. Three of these patients were nourished through selenium-free enteral nutritional products, 1 through selenium-deficient PN and 1 through PN and a formula with reduced selenium. After selenium supplement therapy for 1 year, all 5 patients exhibited improvement in their serum selenium levels and clinical features of selenium deficiency. It is important to be cautious about secondary selenium deficiency in children and adolescents nourished only through EN/PN without an adequate dose of selenium.
authors.affiliation: Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan. Electronic address: yuri@mch.pref.osaka.jp.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Etani
authors.affiliation: Department of Nutrition, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nishimoto
authors.affiliation: Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Kawamoto
authors.affiliation: Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Shouji
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.affiliation: Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Ida
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010288:Parenteral Nutrition; D012643:Selenium / Q000008:administration & dosage / Q000172:deficiency*; D055815:Young Adult
chemical_list: D012643:Selenium
keywords: Child; Elemental diet; Enteral nutrition; Parenteral nutrition; Selenium deficiency