Keshan disease

Keshan disease
Synonyms
Pronounce	N/A
Specialty	Cardiology, Endocrinology
Symptoms	Cardiomyopathy, heart failure, arrhythmia, edema
Complications	Heart failure, cardiac arrest
Onset	Typically in children and women of childbearing age
Duration	Chronic
Types	N/A
Causes	Selenium deficiency, Coxsackievirus infection
Risks	Living in selenium-deficient regions, poor diet
Diagnosis	Clinical diagnosis, Echocardiogram, Electrocardiogram
Differential diagnosis	Dilated cardiomyopathy, Myocarditis
Prevention	Selenium supplementation
Treatment	Selenium supplementation, supportive care
Medication	N/A
Prognosis	Variable, can be severe if untreated
Frequency	Endemic in certain regions of China
Deaths	N/A

Keshan disease is disease caused by selenium deficiency in combination with a second stress (possibly a viral infection).

Role of selenium

• Selenium an element that the body needs to function properly.
• The patients are alsoSelenium is an important component of selenoproteins, such as selenoprotein P, deiodinase, and GPx enzymes

Epidemiology

Keshan disease (KD) is an endemic cardiomyopathy first reported in Keshan County in China in 1935.

Chinese supplementation

Before the Chinese government selenium supplementation program in the 1970's, adults in the Keshan disease areas had average selenium intakes of no more than 11 mcg/day; intakes of at least 20 mcg/day protect adults from Keshan disease.

Signs and symptoms

The clinical manifestations of KD are acute or chronic episodes of heart disease characterized by the following signs and symptoms:

• cardiogenic shock,
• ppcongestive heart failure[[,
• arrhythmia,
• cardiomegaly

Types

Based on the presentation and onset of symptoms, the following four types are described:

1. acute KD,
2. subacute KD,
3. chronic KD, and
4. latent KD.

Diagnosis

Diagnosis is based on a combination of blood tests including selenium levels, EKG, echocardiography etc.

Treatment

The treatment for Keshan disease is supportive care for the heart failure, and low dose selenium supplementation.

Sources of selenium

• Brazil nuts, seafoods, and organ meats are the richest food sources of selenium
• Other sources include muscle meats, cereals and other grains, and dairy products
• The amount of selenium in drinking water is not nutritionally significant in most geographic regions
• The major food sources of selenium in the American diet are breads, grains, meat, poultry, fish, and eggs.

Dose

The recommended amounts are

• 55 micrograms of selenium per day for adult men and women,
• 60 micrograms a day for women during pregnancy and
• 70 micrograms per day for women after pregnancy

Dietary supplementation

• Selenium is available in multivitamin/multimineral supplements and as a stand-alone supplement, often in the forms of selenomethionine or of selenium-enriched yeast (grown in a high-selenium medium) or as sodium selenite or sodium selenate.
• The human body absorbs more than 90% of selenomethionine but only about 50% of selenium from selenite

Other diseases

• Selenium deficiency is also associated with male infertility and might play a role in Kashin-Beck disease, a type of osteoarthritis that occurs in certain low-selenium areas of China, Tibet, and Siberia.
• Selenium deficiency could exacerbate iodine deficiency, potentially increasing the risk of cretinism in infant