Open AccessA Syndrome of Acute Zinc Deficiency During Total Parenteral Alimentation in Man
Author(s) -
Ronald G. Kay,
C Tasman-Jones,
John Pybus,
Roger L. Whiting,
Harry Black
Publication year - 1976
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197604000-00001
Subject(s) - medicine , acrodermatitis enteropathica , zinc deficiency (plant disorder) , zinc , diarrhea , endocrinology , parenteral nutrition , acrodermatitis , physiology , anabolism , weight gain , urinary system , catabolism , gastroenterology , metabolism , body weight , micronutrient , pathology , materials science , alternative medicine , metallurgy
Changes in the plasma and urine levels of the trace metal zinc have been followed in a series of 37 adult patients totally supported by intravenous alimentation. Copper has also been determined in more recent cases. In such a seriously ill group, although urinary zinc loss may be very high at the height of catabolism, severe plasma depletion does not occur unless there is a subsequent phase of sustained anabolism and weight gain. In four patients plasma zinc fell to very low levels during this phase and three of this group developed a syndrome characterized by diarrhea, mental depression, para-nasal, oral and peri-oral dermatitis, and alopecia. The response to oral or intravenous zinc therapy is striking, except for hair regrowth which is delayed but eventually complete. The syndrome we have recognized in adult man has not been previously described. It resembles however the parakeratosis of zinc deficient swine and it is also very similar to Acrodermatitis enteropathica, a genetically determined disorder of infants very recently linked to zinc deficiency. Zinc is clearly essential to human metabolism and it should be included in all parenteral alimentation regimes particularly during the period of rapid, sustained, weight gain.