Document Detail


Acute selenium toxicity associated with a dietary supplement.
MedLine Citation:
PMID:  20142570     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 microg/d (recommended dietary allowance is 55 microg/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 microg/L (reference range, < or =125 microg/L). The mean initial urine selenium concentration of 7 patients was 166 microg/24 h (reference range, < or =55 microg/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.
Authors:
Jennifer K MacFarquhar; Danielle L Broussard; Paul Melstrom; Richard Hutchinson; Amy Wolkin; Colleen Martin; Raymond F Burk; John R Dunn; Alice L Green; Roberta Hammond; William Schaffner; Timothy F Jones
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Archives of internal medicine     Volume:  170     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-03-11     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  256-61     Citation Subset:  AIM; IM    
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Alopecia / chemically induced*,  epidemiology
Child
Child, Preschool
Dietary Supplements / poisoning*
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Gastrointestinal Diseases / chemically induced*,  epidemiology
Humans
Incidence
Male
Middle Aged
Questionnaires
Retrospective Studies
Risk Factors
Selenium / administration & dosage,  poisoning*
Selenium Compounds / administration & dosage,  poisoning*
Time Factors
Young Adult
Grant Support
ID/Acronym/Agency:
DK058763/DK/NIDDK NIH HHS; R01 DK058763-10/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Selenium Compounds; 7782-49-2/Selenium
Comments/Corrections
Comment In:
Arch Intern Med. 2010 Feb 8;170(3):261-3   [PMID:  20142571 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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