2025 Volume 58 Issue 5 Pages 258-264
The patient was a 43‒year‒old woman who developed short bowel syndrome 23 years ago. Dialysis was initiated five months prior to this hospitalization due to end‒stage renal failure caused by repeated dehydration and oxalic acid nephropathy. Her serum selenium concentration (Se) was 6.2 μg/dL at the start of dialysis. She was hospitalized due to a cuff‒type catheter infection and low body weight, and treated with selenium‒free central venous nutrition. The left ventricular ejection fraction (EF) was 69％ at the time of admission, but on the 65th day of hospitalization, EF was found to be 27％ and Se was 2.2 μg/dL； the patient was suspected to have cardiomyopathy due to selenium deficiency, and so sodium selenite at 100 μg/day was started. EF was 42％ and Se was 8.1 μg/dL on the 92th day of hospitalization, and 60％ and 10.7 μg/dL, respectively, on the 120th day of hospitalization, leading to a diagnosis of cardiomyopathy due to selenium deficiency, and sodium selenite administration was stopped. However, on the 150th day of hospitalization, Se decreased to 5.0 μg/dL. Sodium selenite administration was consequently resumed, and the Se level has remained at around 9 μg/dL.
