Keshan is a remote county in northeast China. Residents of this county and others developed a cardiomyopathy of uncertain etiology and poor prognosis.
Its pathogenesis is uncertain. Hypotheses include:
(1) selenium deficiency (related to selenium-deficient soil)
(2) mycotoxin
(3) mitochondrial damage
(4) altered gut flora
(5) viral myocarditis
Clinical features:
(1) dilated cardiomyopathy with heart failure and cardiac arrhythmias
(2) decrease levels of glutathione peroxidase (GPx-1) activity
(3) residence in an endemic region
(4) family history of Keshan disease
(5) exclusion of other causes of cardiomyopathy
Categories based on clinical features:
(1) latent
(2) acute
(3) subacute
(4) chronic
