Risk factors for zinc deficiency in a patient with sickle cell anemia:
(1) increased urinary loss (associated with renal tubular disorder)
(2) iron chelation therapy (deferoxamine, others)
(3) cirrhosis
(4) hemolytic crises
(5) malnutrition or poor dietary intake
(6) other risk factors for zinc deficiency (see above)
Complications of zinc deficiency:
(1) increased pain crises
(2) hyperammonemia, especially with cirrhosis (secondary to inhibition of urea cycle related to decreased activity of ornithine transcarbamylase)
(3) increased copper absorption from the gastrointestinal tract
A person with sickle cell anemia should be screened for zinc deficiency and treated if it is identified.
