Keshan disease
Keshan disease is a selenium-deficient condition characterized primarily by a dilated cardiomyopathy, resulting in congestive cardiac failure, cardiomegaly, and, on occasion, fulminant cardiogenic shock. It most commonly presents in young children and menstruating women.
Historically it was originally found in China, in an area called Keshan in the country's north-east . Since then multiple additional Chinese regions with endemic selenium deficiency due to a lack of the element in the topsoil, have been found.
It seems that in the majority of cases an additional trigger, e.g. Coxsackievirus, was also present.
Most cases show a good response to increased selenium in the diet.