ノート
小児栄養サポートチームによるセレン欠乏症への介入経験
重症2症例での検討
キーワード:
total parenteral nutrition,
selenium deficiency,
nutrition support,
serum selenium concentration
2019 年 45 巻 3 号 p. 150-158
詳細
2019 年 45 巻 3 号 p. 150-158
Pediatric patients who are nutritionally dependent on total parenteral nutrition or some type of therapeutic formula during perioperative periods or intensive chemotherapy are at a high risk of selenium (Se) deficiency. We herein report that the pediatric nutrition support team (pNST) was successfully able to perform early alimental interventions in 2 cases with selenium deficiency. Case 1: A ten-month-old girl with Langerhans cell histiocytosis developed protein-loss gastrointestinal disease with hypoalbuminemia and Se deficiency with nail whitening. The serum Se concentration was at an extremely low level (2.2 μg/dL ). The administration of sodium selenite recovered serum levels of Se up to 7.7 μg/dL one month later. Case 2: A five-year-old boy that had Tetralogy of Fallot with severe cyanosis had received long-term total parenteral nutrition for refractory diarrhea after surgery. The pNST diagnosed asymptomatic Se insufficiency by a low level of serum Se (7.0 μg/dL). Thus, the pNST recommended the administration of sodium selenite for the patient. The patient was successfully treated with Se supplementation to prevent overt Se deficiency. Our experiences suggest that the monitoring of serum Se concentrations is important to prevent or improve Se deficiency in pediatric patients receiving intensive care.
