Acute selenium poisoning by paradise nuts (Lecythis ollaria)

Two previously healthy women developed nausea, vomiting, headache and dizziness for several days, a massive hair loss about 2 weeks later and a discoloration of the fingernails. Detailed diagnostic procedures did not reveal any pathological results. Therapeutic measures did not show any effect. Thallium and arsenic were within normal range in plasma. Delayed quantitative determination of selenium in blood, however revealed toxic values (in case I: 479 mu g/L of serum, 8 weeks after ingestion, and in case II 300 mu g/L of serum, 9 weeks after ingestion). In retrospect, a relation to the ingestion of paradise nuts could be established.