Zinc deficiency and its management in the pediatric population: A literature review and proposed etiologic classification

Summary The essential trace element zinc (Zn) plays a key role in the development, differentiation and growth of various human tissues. Zinc homeostasis is primarily regulated by two zinc transporter families (solute‐linked carrier families, SLC). Disturbances in zinc metabolism may give rise to disorders that typically manifest themselves on the skin. An autosomal recessive zinc deficiency disorder, acrodermatitis enteropathica is caused by a mutation in the gene coding for the ZIP4 transporter. Due to intestinal malabsorption, affected infants develop clinical signs and symptoms shortly after weaning. Acquired zinc deficiency is a rare but underdiagnosed disorder associated with various etiologies and variable clinical manifestations. Depending on the patient's age, a multitude of causes have to be considered. Given the characteristic periorificial and acral lesions, the clinical diagnosis is usually made by dermatologists. Laboratory confirmation includes measurement of plasma zinc levels and – as a supplementary measure – zinc‐dependent enzymes such as alkaline phosphatase. Oral zinc replacement therapy frequently leads to clinical remission within a few days. Depending on the cause, disease management should include cooperation with pediatricians and gastroenterologists in order to guarantee optimal patient care.

show abstract

“…Corbo et al. have proposed a classification into four different types, based on the underlying etiology (Table ).…”

Section: Etiologymentioning

confidence: 99%

Zinc and skin: an update

Glutsch

Hamm

Goebeler

2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

show abstract

“…9 Unlike AE, TNZD is limited to the duration of exclusive breastfeeding. 10 Premature infants have multifactorial risk factors that predispose to a zinc deficiency, including: a high metabolic demand due to extremely rapid growth inadequate total body stores from failure to establish third trimester transplacental acquisition of hepatic zinc stores; parenteral alimentation predisposing to zincuria and inadequate parenteral zinc supply; immature intestinal zinc conservation; increased urinary zinc losses; exposure to zinc chelating medications (e.g. 2 Zinc deficiency is a multi-system disorder with extra-dermal features that may aid in early diagnosis and treatment prior to progression to fulminant pathognomonic dermal disease.…”

Section: Discussionmentioning

confidence: 99%

Transient neonatal zinc deficiency in exclusively breastfed preterm infants

Watson

Cartwright

Jardine

et al. 2017

J Paediatrics Child Health

View full text Add to dashboard Cite

“…It is important to differentiate TZD‐MB from acrodermatitis enteropathica (AE), which has a similar skin presentation but results from a loss‐of‐function mutation in the SLC39A4 gene (ZIP4) that impairs intestinal zinc absorption . AE presents with a classic triad of diarrhea, alopecia, and perioral–perianal rash .…”

Section: Discussionmentioning

confidence: 99%