Masumoto Kouji, Nagata Kouji, Higashi Mayumi, Nakatsuji Takanori, Uesugi Toru, Takahashi Yukiko, Nishimoto Yuko, Kitajima Junko, Hikino Shunji, Hara Toshiro, Nakashima Kazue, Nakashima Kazuhiro, Oishi Ryozo, Taguchi Tomoaki
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Nutrition. 2007 Nov-Dec;23(11-12):782-7. doi: 10.1016/j.nut.2007.08.001. Epub 2007 Sep 12.
Selenium deficiency is a known complication in patients requiring long-term nutritional support; however, the clinical features of selenium deficiency in infants have not been completely described. We describe the clinical features of selenium deficiency in infants.
Six infants with selenium deficiency were studied retrospectively, with a focus on the period of nutritional support, the clinical symptoms, and the chronologic changes in serum selenium concentrations before and after the administration of selenite.
The onset of selenium deficiency in five patients occurred at <6 mo of age; selenium deficiency occurred in one patient 14 mo after birth. One patient received parenteral nutrition for 15 mo after birth; the other five patients primarily received an elemental diet for 2-6 mo. In all patients, growth retardation and alopecia with pseudoalbinism were the characteristic symptoms of selenium deficiency. At the time of diagnosis, the serum selenium level in four patients was <2.0 microg/dL and serum selenium levels in two patients were 3.2 and 3.3 microg/dL, respectively. The resolution of hair symptoms corresponded to the level of serum selenium after 1-2 mo and a rapid improvement in growth occurred in all patients after the administration of selenite.
The early clinical symptoms of selenium deficiency in infants include growth retardation and alopecia with pseudoalbinism, which are reversible if the patients are treated with adequate amounts of selenite. Clinicians who manage infants receiving long-term nutritional support, including an elemental diet, should be aware of the symptoms associated with selenium deficiency.
硒缺乏是需要长期营养支持的患者中一种已知的并发症；然而，婴儿硒缺乏的临床特征尚未得到完整描述。我们描述了婴儿硒缺乏的临床特征。
对6例硒缺乏婴儿进行回顾性研究，重点关注营养支持期、临床症状以及亚硒酸盐给药前后血清硒浓度的时间变化。
5例患者在6月龄前出现硒缺乏；1例患者在出生后14个月出现硒缺乏。1例患者出生后接受了15个月的肠外营养；其他5例患者主要接受了2 - 6个月的要素饮食。所有患者中，生长发育迟缓以及伴有假性白化病的脱发是硒缺乏的特征性症状。诊断时，4例患者的血清硒水平<2.0微克/分升，2例患者的血清硒水平分别为3.2和3.3微克/分升。毛发症状的缓解与1 - 2个月后的血清硒水平相对应，所有患者在给予亚硒酸盐后生长迅速改善。
婴儿硒缺乏的早期临床症状包括生长发育迟缓和伴有假性白化病的脱发，如果患者接受适量亚硒酸盐治疗，这些症状是可逆的。管理接受长期营养支持（包括要素饮食）婴儿的临床医生应了解与硒缺乏相关的症状。
