Proximal muscle weakness and selenium deficiency associated with long term parenteral nutrition

• Published in: The American journal of clinical nutrition Vol. 43; no. 4; pp. 549 - 554
• Main Authors: Brown, MR, Cohen, HJ, Lyons, JM, Curtis, TW, Thunberg, B, Cochran, WJ, Klish, WJ
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.1986
• Subjects: Adult; Female; Glutathione Peroxidase - metabolism; glutathione peroxidase activity; Glutathione Reductase - metabolism; Humans; Muscular Atrophy - etiology; parenteral nutrition; Parenteral Nutrition, Total - adverse effects; Proximal muscle weakness; Pyruvate Kinase - metabolism; Selenious Acid; Selenium - blood; Selenium - deficiency; Selenium - therapeutic use; parenteral nutrition; Proximal muscle weakness; glutathione peroxidase activity; selenium deficiency
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/43.4.549

A 33-yr-old white female with short bowel syndrome secondary to trauma was maintained on home parenteral nutrition for 4 yr when her plasma, red cell, white cell, and platelet glutathione peroxidase (GSHPx) activities were found to be extremely low, as were her plasma and red cell selenium levels. During her first year on parenteral nutrition she noted the onset of an inability to rise from a squatting position, rapid tiring when stair climbing, and weakness when attempting to lift large or moderately heavy objects. Treatment with 400 µg/d of selenious acid intravenously was associated with a disappearance of her symptoms and an increase in proximal muscle strength within 6 wk. The plasma and red cell selenium levels, and the plasma and white cell GSHPx activities rose to normal levels within 6 wk. Red cell GSHPx activity returned to normal by 3 mo.