Spiller Henry A, Pfiefer Eric
Kentucky Regional Poison Center, PO Box 35070, Louisville, KY 40232-5070, USA.
Forensic Sci Int. 2007 Aug 24;171(1):67-72. doi: 10.1016/j.forsciint.2006.06.077. Epub 2006 Aug 7.
Two patients, a 36-year-old female and a 36-year-old male, separately experienced new onset nausea, vomiting, diarrhea, abdominal pain, muscle weakness and pallor. Over a period of 14-16 h these symptoms continue and progress to include hypotension refractory to therapy, pulmonary edema and cardiovascular collapse. Autopsies show hemorrhagic pulmonary edema, splenomegaly and lack of anatomical cause for sudden death. Postmortem analysis, in one case post-embalming and exhumation, revealed elevated selenium concentrations and a determination of the cause of death. These two cases present several important features associated with selenium toxicity, two of which are previously unreported: (1) selenium as a potential homicidal agent, (2) the toxidrome and time frame of selenium toxicity, (3) selenium determination in exhumed, embalmed tissues, (4) postmortem urinary selenium concentration, and (5) decrease in tissue concentrations over time.
两名患者，一名36岁女性和一名36岁男性，分别出现了新发的恶心、呕吐、腹泻、腹痛、肌肉无力和面色苍白症状。在14至16小时内，这些症状持续并进展，包括对治疗无效的低血压、肺水肿和心血管衰竭。尸检显示出血性肺水肿、脾肿大且无解剖学上的猝死原因。在一例病例中，经过尸体防腐处理和挖掘尸体后的尸检分析显示硒浓度升高并确定了死因。这两例病例呈现出与硒中毒相关的几个重要特征，其中两个此前未被报道：（1）硒作为一种潜在的杀人剂；（2）硒中毒的中毒综合征和时间框架；（3）挖掘出的、经过防腐处理的组织中的硒测定；（4）死后尿硒浓度；（5）组织浓度随时间下降。
