Ketogenic diet: rapid onset of selenium deficiency-induced cardiac decompensation.
Level 4 - case-series / case-control
Individual clinical case report
PubMed 22367552 · doi:10.1007/s00246-012-0219-6
What was done
Clinical case report of a 5-year-old boy receiving a ketogenic diet for intractable seizures who developed acute cardiac decompensation during hospitalization for elective surgery, prior to his scheduled 3-month laboratory evaluation. Baseline and perioperative serum selenium levels, cardiac findings, and response to diet discontinuation and selenium repletion were documented.
What was found
The abstract reports that the patient had a normal baseline serum selenium level before diet initiation, but subsequently developed acute reversible cardiomyopathy and ventricular tachycardia, accompanied by a markedly low serum selenium level. Following cessation of the ketogenic diet and initiation of selenium supplementation, rapid clinical improvement was observed. Specific numerical values for selenium levels and cardiac function parameters were not provided in the abstract.
Why it matters
This report highlights that life-threatening selenium deficiency and cardiomyopathy can occur rapidly after initiating a ketogenic diet, potentially prior to routine 3-month monitoring intervals. It suggests consideration of preoperative electrocardiography, echocardiography, and selenium measurement in patients on a ketogenic diet undergoing elective surgery.
Limits
Findings are based on a single patient (n = 1), preventing generalization or frequency estimation. The abstract omits quantitative laboratory concentrations, diet composition details, and cardiac metrics. Perioperative stressors may have confounded the clinical presentation.
Cited by
- supports Poorly formulated ketogenic diets have led to selenium deficiency and fatal cardiomyopathy in published case reports.