Selenium deficiency during total parenteral nutrition--a case report.

THE trace element selenium has recently been recognised as an essential constituent of the enzyme glutathione peroxidase (GSHPx, EC 1.11.1.9) which is thought to have a major function in the removal of hydrogen peroxide and other organic hydroperoxides generated during oxidative metabolism.' Both selenium and vitamin E appear to protect against a myopathic condition seen in young animals put to pasture in spring after being fed indoors during the winter; this condition has been observed in England, Scotland and Northern Ireland.2 Keshan disease is a fatal cardiomyopathy seen in children who live in a region in China where selenium levels are low in staple foods.3 There have been few reports of selenium deficiency during long-term total parenteral nutrition.4 5Currently available intravenous nutritional solutions contain negligible amounts of selenium.5