Zone 1 Hepatocellular Necrosis: A Manifestation of Selenium Toxicity?

This case report described a 51-year-old female with Graves' disease who developed liver issues after taking high-dose selenium supplements for at least 6 weeks. She experienced symptoms such as jaundice, somnolence, and tremor, with liver tests showing abnormal results. A liver biopsy revealed zone 1 necrosis, indicative of toxic injury, which was linked to selenium toxicity. The patient's symptoms improved after discontinuing selenium. The study highlighted that while selenium is essential for human health, 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 of selenium.