Low selenium level in severe rheumatoid arthritis.

Serum selenium concentrations were measured in 87 patients with rheumatoid arthritis. The serum selenium levels of the whole group of patients was significantly reduced (70.2 +/- 13.3 micrograms/l, p less than 0.001) when compared with the reference material (79.8 +/- 10.6 micrograms/l). However, the reduction was not equally pronounced in three groups of patients representing different courses of the disease. One group with an active, disabling disease of long duration had a very reduced serum selenium level (63.7 +/- 14.1 micrograms/l, p less than 0.001). Another group, with a protracted but mild disease had a slightly reduced level (74.1 +/- 10.8 micrograms/l, p less than 0.01), and a group with mild disease of short duration had a slightly but not significantly reduced selenium level (75.9 +/- 10.8 micrograms/l, p less than 0.1). Significant correlation was found between serum selenium and the number of joints with limitation of motion, number of joints with active arthritis, haemoglobin concentration and IgG concentration. No correlation was found between serum selenium and disease duration, morning stiffness, ESR, C-reactive protein, rheumatoid factor titre, serum albumin, IgM and IgA. Selenium is part of the enzyme glutathione peroxidase that catabolizes peroxides which are suggested to be actively involved in inflammation. A low selenium level may thus be a further factor in the pathogenesis of rheumatoid arthritis.