Fujita Yuya, Chida-Nagai Ayako, Shibukawa Naoyuki, Tatsunori Itabashi, Suzuki Yuto, Sasaki Daisuke, Yamazawa Hirokuni, Takeda Atsuhito
Department of Pediatrics, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Pediatrics, Self Defense Forces Sapporo Hospital, Sapporo, Hokkaido, Japan.
Department of Pediatrics, Hokkaido University, Sapporo, Hokkaido, Japan.
JACC Case Rep. 2025 Aug 20;30(24):104665. doi: 10.1016/j.jaccas.2025.104665.
Selenium deficiency can cause cardiomyopathy; however, the underlying mechanisms remain unclear. We report a case of cardiomyopathy associated with selenium deficiency in a patient with long-term enteral nutrition.
A 2-year-old boy with gastrointestinal allergy developed secondary cardiomyopathy due to selenium deficiency resulting from an elemental diet. He presented with reduced left ventricular function and dilated ventricles. Serum selenium levels were undetectable. Myocardial scintigraphy showed perfusion-metabolism mismatches and fibrosis. Selenium supplementation and medications for heart failure led to significant cardiac recovery over a period of 1 year.
The patient's congenital heart disease allowed for evaluation before the onset of selenium deficiency cardiomyopathy. Myocardial scintigraphy revealed a characteristic perfusion-metabolism imbalance. Both selenium supplementation and treatment for ischemic heart disease were effective in improving cardiac function.
TAKE-HOME MESSAGES: Myocardial scintigraphy is useful in diagnosing selenium deficiency cardiomyopathy. Selenium supplementation and management of ischemic heart disease are essential for treatment.
硒缺乏可导致心肌病；然而，其潜在机制仍不清楚。我们报告一例长期肠内营养患者发生的与硒缺乏相关的心肌病病例。
一名2岁胃肠道过敏男孩因要素饮食导致硒缺乏继发心肌病。他表现为左心室功能减退和心室扩张。血清硒水平检测不到。心肌闪烁显像显示灌注 - 代谢不匹配及纤维化。补充硒及使用心力衰竭药物治疗1年后心脏显著恢复。
患者的先天性心脏病使得在硒缺乏性心肌病发病前得以进行评估。心肌闪烁显像显示出特征性的灌注 - 代谢失衡。补充硒及治疗缺血性心脏病均对改善心功能有效。
心肌闪烁显像对诊断硒缺乏性心肌病有用。补充硒及管理缺血性心脏病对治疗至关重要。
