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| Zinc deficiency |
A collection of growth retardation, hypogonadism, cell mediated immune dysfunction, and skin changes related to decreased zinc
SIGNS AND SYMPTOMS:
•Mild deficiency
•Hypogeusia
•Decreased dark adaptation
•Decreased lean body mass
•Moderate deficiency
•All of the above
•Diarrhea
•Growth retardation
•Hypogonadism (especially male)
•Mental lethargy
•Anergy
•Rough skin
•Delayed wound healing
•Glucose intolerance
•Impaired cell mediated immunity
•Severe deficiency
•All of the above
•Bullous pustular dermatitis
•Weight loss
•Dwarfism
•Emotional instability
•Tremors
•Ataxia
•Alopecia
•Death
CAUSES:
•Increased requirements
•Pregnancy
•Lactation
•Rapid growth phase of childhood
•Burns
•Major trauma
•Increased losses
•Diabetes
•Cirrhosis
•Renal disease
•Malabsorption states, e.g., inflammatory bowel diseases
•Sickle cell anemia
•Decreased absorption
•Acrodermatitis enteropathica, an autosomal recessive deficiency in the enzyme required for
intestinal absorption
•Geophagia
•Chelating agents
•Parasitism
•Diet high in phytates
•Insufficient dietary intake
•Vegetarianism
•Parenteral hyperalimentation without supplementation
•Breast feeding
•Suboptimal zinc conditions in diet (rare)
•Alcoholism
RISK FACTORS:
•High milk consumption
•Low socioeconomic status
LABORATORY:
•Plasma zinc levels decreased (in moderate to severe zinc deficiency)
•Erythrocyte or leukocyte zinc levels more adequately assess tissue stores, but these are more
costly and not widely available
•Hair or fingernail zinc levels not useful
DIET:
•Balanced omnivorous diet
•Avoid excessive intake of foods with high phytate content, (e.g., cereals)
DRUG(S) OF CHOICE:
•Zinc gluconate or zinc sulfate for 6-9 months
•Elemental zinc added to hyperalimentation in adult patient.
•In pediatric patients, 0.02-0.04 mg zinc/kg/day in hyperalimentation
•Prenatal vitamins with minerals during pregnancy and lactation to prevent deficiency
PREVENTION/AVOIDANCE:
•Adequate diet
•Supplementation when indicatedLabels: zinc deficiency |
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