[Two cases of long-term home parenteral nutrition in which increased doses of intravenous selenium were administered and the serum and hair selenium concentration was measured].

Care should be taken regarding the intravenous administration of selenium (Se), an essential element, which is known to be associated with toxemia. The concentration of Se in the serum and hair of 2 patients (patient A and B) with short bowel syndrome, undergoing long-term home parenteral nutrition (HPN), was measured. As nutritional management, commercial total parenteral nutrition infusion was used without restricting oral intake. The patients received sodium selenite (Na2O3Se x 5H2O), a hospital preparation, at the Toho University Omori Medical Center. The dosage was gradually increased from 40 microg/ week to 120 micog/week over 17 months, and the Se concentration in serum and hair was measured bimonthly using inductively coupled plasma mass spectrometry (ICP-MS). The serum concentration of Se increased from 2.0 to 5.3 microg/dL and from 9.0 to 9.7 microg/dL in the case of patient A and B, respectively; however, it did not reach the average value that was observed in healthy volunteers (11.8 microg/dL). In contrast, the concentration of Se in hair gradually approached the reference value (reference range, 405-784 ppb at color correction criteria range 217-520 ppb) in the case of patient A (change from 189 to 278 ppb) and B (change from 291 to 200 ppb). Therefore, we were able to safely manage these cases without any deficiency and poisoning symptoms, by gradually increasing the administration doses.