Köppel C, Baudisch H, Beyer K H, Klöppel I, Schneider V
J Toxicol Clin Toxicol. 1986;24(1):21-35. doi: 10.3109/15563658608990443.
Two hours after suicidal ingestion of an unknown amount of selenium dioxide, a 17-year-old male was admitted to hospital with asystolia and apnea. Attempts at resuscitation failed and the patient was pronounced dead. Findings at autopsy included congestion of lungs and kidneys, diffuse swelling of the heart, and brain edema. The most impressive finding was an orange-brown discoloration of the skin and all viscera, probably due to hemolysis and/or pigmentation related to ingestion of selenium dioxide. Selenium blood and tissue levels were increased by a factor of 100-1000 as compared to normal. The highest concentrations were found in pancreas, spleen, liver, and adipose tissue. For elucidation of the chemical nature of selenium in tissues, a new analytical method which was based on carbon disulfide extraction was developed. Carbon disulfide is a good solvent for non-polar selenium compounds like elemental selenium and selenium disulfide, but not for polar compounds like selenite and selenoproteins. A major fraction of selenium in tissues was extractable by carbon disulfide, which seems to indicate the presence of elemental selenium and/or selenium disulfide. The color of these substances is red and orange, respectively. This might explain at least part of the discoloration of skin and tissues. In vitro experiments suggested that trace amounts of hydrogen selenide, which is an intermediate of selenite metabolism, probably induced hemolysis. For evaluation of the therapeutic value of hemoperfusion in selenium poisoning in vitro hemoperfusion experiments were performed, which revealed only a moderate effect on selenium blood levels.
一名17岁男性在自杀性摄入未知量二氧化硒两小时后，因心搏停止和呼吸暂停被送入医院。复苏尝试失败，患者被宣告死亡。尸检结果包括肺和肾充血、心脏弥漫性肿大以及脑水肿。最显著的发现是皮肤和所有内脏呈橙褐色变色，这可能是由于二氧化硒摄入导致的溶血和/或色素沉着。与正常情况相比，血液和组织中的硒水平升高了100 - 1000倍。在胰腺、脾脏、肝脏和脂肪组织中发现了最高浓度的硒。为了阐明组织中硒的化学性质，开发了一种基于二硫化碳萃取的新分析方法。二硫化碳是元素硒和二硫化硒等非极性硒化合物的良好溶剂，但不是亚硒酸盐和硒蛋白等极性化合物的良好溶剂。组织中大部分硒可被二硫化碳萃取，这似乎表明存在元素硒和/或二硫化硒。这些物质的颜色分别为红色和橙色。这可能至少部分解释了皮肤和组织的变色现象。体外实验表明，亚硒酸盐代谢中间体微量的硒化氢可能会引起溶血。为了评估血液灌流在硒中毒中的治疗价值，进行了体外血液灌流实验，结果显示其对血液硒水平只有中等程度的影响。
