Zone 1 Hepatocellular Necrosis: A Manifestation of Selenium Toxicity?

This document reported a case of suspected selenium hepatotoxicity in a 51-year-old female with Graves' disease, who developed liver issues after taking high-dose selenium supplements for at least 6 weeks. The patient experienced right upper quadrant pain, jaundice, and abnormal liver biochemistries. A liver biopsy showed zone 1 necrosis, indicative of toxic injury. After discontinuing selenium, her symptoms improved. The study highlighted that while selenium is essential, excessive intake can lead to toxicity, including focal hepatic necrosis. It emphasized the importance of physicians being aware of the risks associated with over-supplementation.