Plasma- and erythrocyte-selenium concentrations were determined in five consecutive patients with Crohn's disease given preoperative total parenteral nutrition - nil per os - for a mean period of 34 days per patient. No blood components were administered during the total parenteral nutrition. Before the total parenteral nutrition the plasma-selenium level and, to a less extent, the erythrocyte-selenium levels were below the reference values. After three weeks of total parenteral nutrition both concentrations had fallen. There were, however, clinical and biochemical signs of improvement during the total parenteral nutrition, as indicated by an increase in body weight, P-albumin and P-transferrin. In one female patient given 39 days of preoperative total parenteral nutrition containing 0.06 mumol (5 micrograms) selenium per 24 h the decreasing levels of plasma-selenium and erythrocyte-selenium were both correlated to the duration of the total parenteral nutrition (r = 0.87 and 0.96, respectively). The results suggest that total parenteral nutrition patients may be at risk for selenium deficiency, and that a supplementary administration of selenium via total parenteral nutrition may be required.
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