TY  - JOUR
PY  - 2010//
TI  - Acute selenium toxicity associated with a dietary supplement
JO  - Archives of internal medicine
A1  - Macfarquhar, Jennifer K.
A1  - Broussard, Danielle L.
A1  - Melstrom, Paul
A1  - Hutchinson, Richard
A1  - Wolkin, Amy
A1  - Martin, Colleen
A1  - Burk, Raymond F.
A1  - Dunn, John R.
A1  - Green, Alice L.
A1  - Hammond, Roberta
A1  - Schaffner, William
A1  - Jones, Timothy F.
SP  - 256
EP  - 261
VL  - 170
IS  - 3
N2  - 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, </=125 mug/L). The mean initial urine selenium concentration of 7 patients was 166 mug/24 h (reference range, </=55 mug/24 h). CONCLUSIONS: Toxic concentrations of selenium in a liquid dietary supplement resulted in a widespread outbreak. Had the manufacturers been held to standards used in the pharmaceutical industry, it may have been prevented.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-9926
UR  - http://dx.doi.org/10.1001/archinternmed.2009.495
ID  - ref1
ER  -