Zinc Deficiency Disease

DESCRIPTION

Constellation of growth retardation, hypogonadism, cell mediated immune dysfunction, and skin changes related to decreased zinc

System(s) affected: Endocrine/Metabolic, Skin/Exocrine, Nervous
Genetics: Usually acquired, but rarely acrodermatitis enteropathica (autosomal recessive) and associated with sickle cell anemia (autosomal recessive
Incidence/Prevalence in USA: Unknown
Predominant age: All ages, most often adolescent
Predominant sex: Male = Female

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

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

N/A

SPECIAL TESTS

N/A

IMAGING

N/A

DIAGNOSTIC PROCEDURES

N/A

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

N/A

SURGICAL MEASURES

N/A

ACTIVITY

Full activity

DIET

Balanced omnivorous diet
Avoid excessive intake of foods with high phytate content (e.g., cereals)

PATIENT EDUCATION

Dietary consultation

PREVENTION/AVOIDANCE

Adequate diet
Supplementation when indicated (see Medications)

POSSIBLE COMPLICATIONS

N/A

EXPECTED COURSE AND PROGNOSIS

Immediate improvement in clinical status. Full resolution of signs and symptoms.

ASSOCIATED CONDITIONS

Sickle cell anemia
Pregnancy and lactation
Alcoholism
Malabsorption
Parenteral hyperalimentation
In the older patient: diabetes, cirrhosis, those taking diuretics

AGE-RELATED FACTORS

Pediatric: Zinc deficiency may cause failure to thrive, impair growth and development of secondary sexual characteristics
Geriatric:

Zinc deficiency may cause poor night vision leading to falls; poor wound healing or chronic skin ulcer; loss of taste which may cause worsening nutrition
Elderly persons living in institutions may have low zinc intake

Others: N/A

PREGNANCY

Requirements increase; deficiency may cause spontaneous abortion, inadequate weight gain

OTHER NOTES

N/A

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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