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Amyotrophic Lateral Sclerosis and Low Urinary Selenium Levels

Forbes H. Norris Jr, MD; Kwei Sang U, MD
JAMA. 1978;239(5):404. doi:10.1001/jama.1978.03280320020010.
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To the Editor. —  In the recent report of selenium exposure and possible intoxication in patients with amyotrophic lateral sclerosis (ALS) by Kilness and Hochberg (237:2843, 1977), the possibility of a coincidental association was noted, and we can report experience substantiating that interpretation. Twenty patients with well-established ALS, including ALS diagnoses by other neurologists prior to our investigation, had 24-hour urine collections analyzed for selenium. Bio-Science Laboratories, Van Nuys, Calif, measured selenium by a chemical reaction method; the Hine Laboratory, San Francisco, used atomic absorption and spectrometry.In 19 cases, both the concentration of the metal and its 24-hour excretion level were in the lower halves of the laboratories' ranges for unexposed persons. One of these patients lived near the South Dakota area reported by Kilness and Hochberg. In another the urine had a borderline elevation for selenium; this patient, had lived her entire life in areas not associated with


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