Citation

Macfarquhar JK, Broussard DL, Melstrom P, Hutchinson R, Wolkin A, Martin C, Burk RF, Dunn JR, Green AL, Hammond R, Schaffner W, Jones TF. Arch. Intern. Med. 2010; 170(3): 256-261.

Affiliation

Tennessee Department of Health, Communicable and Environmental Disease Services, First Floor, Communicable and Environmental Disease Services, Cordell Hull Building, 425 Fifth Ave N, Nashville, TN 37247. Tim.F.Jones@tn.gov.

Copyright

(Copyright © 2010, American Medical Association)

DOI

10.1001/archinternmed.2009.495

PMID

20142570

PMCID

PMC3225252

Abstract

BACKGROUND: Selenium is an element necessary for normal cellular function, but it can have toxic effects at high doses. We investigated an outbreak of acute selenium poisoning. METHODS: A case was defined as the onset of symptoms of selenium toxicity in a person within 2 weeks after ingesting a dietary supplement manufactured by "Company A," purchased after January 1, 2008. We conducted case finding, administered initial and 90-day follow-up questionnaires to affected persons, and obtained laboratory data where available. RESULTS: The source of the outbreak was identified as a liquid dietary supplement that contained 200 times the labeled concentration of selenium. Of 201 cases identified in 10 states, 1 person was hospitalized. The median estimated dose of selenium consumed was 41 749 mug/d (recommended dietary allowance is 55 mug/d). Frequently reported symptoms included diarrhea (78%), fatigue (75%), hair loss (72%), joint pain (70%), nail discoloration or brittleness (61%), and nausea (58%). Symptoms persisting 90 days or longer included fingernail discoloration and loss (52%), fatigue (35%), and hair loss (29%). The mean initial serum selenium concentration of 8 patients was 751 mug/L (reference range,

Language: en