Acquired zinc deficiency can occur with many conditions and may be underdiagnosed. Recognition of the clinical settings and the clinical findings can help identify patients who should have measurement of zinc levels in serum or hair.


Clinical Settings


Mechanisms for deficiency:

(1) absence in absorbable form in diet

(2) failure to absorb

(3) excess loss


Disorders associated with zinc deficiency:

(1) malabsorption syndrome

(2) pancreatic disease

(3) cirrhosis

(4) post-gastrectomy

(5) blind-loop syndrome

(6) mucosal disorders of GI tract, including Crohn's disease

(7) chronic diarrhea

(8) anorexia nervosa or bulimia

(9) total parenteral nutrition without zinc supplementation

(10) dietary deficiency, including faddish diets

(11) burns

(12) postsurgical procedures

(13) malignancy

(14) renal tubular disorders

(15) dialysis

(16) nephrotic syndrome

(17) parasitic infections

(18) bacterial infections

(19) chelation drug therapy

(20) diabetes mellitus

(21) hemolytic anemia

(22) collagen-vascular disease

(23) pregnancy and lactation

(23) breast feeding

(24) therapy with anti-metabolite drugs

(25) high dietary phytate

(26) alcoholism


Clinical Findings


Skin findings:

(1) progressively severe acral dermatitis

(2) rough, dry skin

(3) angular stomatitis (perleche)

(4) seborrheic dermatitis-like eruption

(5) alopecia


Findings in pediatric patients:

(1) neural tube defects (defective embryogenesis)

(2) growth retardation

(3) delayed puberty

(4) hypogonadism in adolescent males


Neurologic and ocular findings:

(1) mental disturbances

(2) decreased sense of taste (hypogeusia)

(3) decreased visual acuity

(4) photophobia


Gastrointestinal findings:

(1) anorexia

(2) variable diarrhea


Changes in host defense:

(1) depressed cell-mediated immunity

(2) impaired wound healing


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