Keshan disease is a congestive cardiomyopathy caused by a combination of dietary deficiency of selenium and the presence of a mutated strain of Coxsackievirus, named after

Keshan County Keshan () is a county in western Heilongjiang province, China, about northeast of Qiqihar, which administers it. It is named from a city-shaped extinct volcano, which has a name of Erkeshan in its territory. Its total area is , with a population ...

Heilongjiang Heilongjiang () formerly romanized as Heilungkiang, is a province in northeast China. The standard one-character abbreviation for the province is (). It was formerly romanized as "Heilungkiang". It is the northernmost and easternmost province ...

province, Northeast China, where symptoms were first noted. These symptoms were later found prevalent in a wide belt extending from northeast to southwest China, all due to

selenium Selenium is a chemical element with the symbol Se and atomic number 34. It is a nonmetal (more rarely considered a metalloid) with properties that are intermediate between the elements above and below in the periodic table, sulfur and tellurium, ...

-deficient soil. The disease peaked in 1960–1970, killing thousands of people. Often fatal, the disease affects children and women of child-bearing age, characterized by heart failure and

pulmonary edema Pulmonary edema, also known as pulmonary congestion, is excessive liquid accumulation in the tissue and air spaces (usually alveoli) of the lungs. It leads to impaired gas exchange and may cause hypoxemia and respiratory failure. It is due t ...

. Over decades, supplementation with selenium reduced this condition. It had been linked to the coxsackie B virus. Current research suggests that the lack of selenium results in a more virulent strain of the coxsackievirus becoming the dominant

viral species Virus classification is the process of naming viruses and placing them into a taxonomic system similar to the classification systems used for cellular organisms. Viruses are classified by phenotypic characteristics, such as morphology, nucleic ...

present in the population of virus, but the mechanism of this selection event is unclear. Keshan disease can also lead to higher rates of cancer, cardiovascular disease, hypertension, and strokes. In addition, an individual can experience eczema, psoriasis, arthritis, cataracts, alcoholism, and infections.

Signs and symptoms

Cardiac arrythmias,dizziness,fast breathing,shortness of breath(PULMONARY EDEMA)

Diagnosis

Prevention

It is hard to consider Keshan disease extremely preventable because the only way to ensure that the individual is getting enough selenium would be to test the soil in the area. However, one way that selenium intake can be improved is to increase intake of foods that are rich with selenium. Examples include Brazil nuts, onions, canned tuna, beef, cod, turkey, chicken breast, enriched pasta, egg, cottage cheese, oatmeal, white or brown rice, and garlic. If the individual lives in an area that does not have selenium enriched soil, dietary supplementation should be considered. To determine whether or not an individual is selenium deficient, blood testing is performed.

Treatments

The treatment for Keshan disease is selenium supplementation. The recommended amounts are fifty-five micrograms of selenium per day for adult men and women, sixty micrograms a day for women during pregnancy and seventy micrograms per day for women after pregnancy. A doctor may insist that if a man is sexually active, he may have to take up to seventy micrograms of selenium per day. A doctor may also recommend that the individual take vitamin E; selenium and

vitamin E Vitamin E is a group of eight fat soluble compounds that include four tocopherols and four tocotrienols. Vitamin E deficiency, which is rare and usually due to an underlying problem with digesting dietary fat rather than from a diet low in vi ...

are medically linked and seem to work together. An individual will also be advised to have a diet that includes seafood, meats such as kidney, and liver, and some grains and seeds; all of these are high in selenium. Brewer's yeast and

wheat germ Cereal germ or Wheat germ: The germ of a cereal is the reproductive part that germinates to grow into a plant; it is the embryo of the seed. Along with bran, germ is often a by-product of the milling that produces refined grain products ...

both contain high levels of selenium. Garlic, onions, mushroom, broccoli, tomatoes, radishes, and Swiss chard may be good sources of selenium if the soil in which they are grown contains it. An individual will have to be monitored once they begin to take the selenium supplements, due to the fact that too much of it can cause balding, intestinal distress, weakness, and slow mental functioning. Individuals in China with the disease treat it with a herb called ''

Astragalus ''Astragalus'' is a large genus of over 3,000 species of herbs and small shrubs, belonging to the legume family Fabaceae and the subfamily Faboideae. It is the largest genus of plants in terms of described species. The genus is native to tempe ...

'', which accumulates selenium from the soil.

Living with Keshan disease

An individual will most likely be prescribed selenium supplements (in the form of selenomethionine) or have injections of this mineral. Other recommendations for managing Keshan disease are to increase consumption of foods rich in selenium in addition to supplements, avoid alcohol, monitor side effects to medications, and increase sleep. Cardiac surgery (implants, stents or full heart transplant) may be advised.

References

External links

{{Heart diseases Heart diseases Mineral deficiencies Enterovirus-associated diseases