長期静脈栄養管理中に不整脈を伴うセレン欠乏症を呈した1乳児例

抄録

We encountered a 4-month-old infant who had arrhythmia during 4 months of total pareteral nutrition (TPN) following ileocolostomy for congenital ileal atresia. Supraventricular and ventricular premature contractions were monitored on ECG. The arrhythmias continued despite administration of antiarrhythmic drugs. In addition, the plasma selenium level was 0.9μg/dl, which was very low for an infant. Arrhythmia due to selenium deficiency was suspected, and selenious acid was added to TPN. Both the electrocardiographic abnormalities and plasma selenium level normalized in 5 days after the administration of selenious acid. The plasma selenium level increased to 6.0μg/dl. In patients receiving TPN, prophylactic selenium supplementation is necessary and plasma selenium levels should be determined regular inervals.