[Zinc deficiency syndrome during long-term parenteral nutrition in a patient with Crohn's disease and cirrhosis of the liver. Casuistry and zinc-pharmacokinetic (author's transl)].
A 29 year old patient with Crohn's disease and posthepatitic HBsAg-positive cirrhosis developed zinc deficiency in the course of complete parenteral nutrition. Zinc deficiency was proven by a low plasma zinc level of 12 microgram/dl. The daily input of zinc was 0.5 mg as calculated from the zinc concentration of infusion solutions used in parenteral nutrition during 3 1/2 months of treatment. The clinical picutre was that of acrodermatitis enteropathica. Cirrhosis of the liver and Crohn's disease were contributory causes of zinc deficiency. 6 bolus injections of 12-36 mg of zinc (total amount 144 mg) were given during 13 days. The plasma zinc level increased to 60-80 microgram/dl. 52% of the total amount of zinc injected were excreted by urine. The plasma half-life times of zinc were independent from basic zinc concentrations and averaged 1.55 +/- 0.22 h. It is concluded that severe signs of zinc deficiency will develop during parenteral nutrition in the presence of conditions leading to a negative zinc balance. In the case of long-term complete parenteral nutrition zinc should be substituted from the beginning of the treatment on.
D000169:Acrodermatitis / Q000209:etiology; D000328:Adult; D003424:Crohn Disease / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007082:Ileum / Q000601:surgery; D008103:Liver Cirrhosis / Q000628:therapy*; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010304:Paronychia / Q000209:etiology; D015032:Zinc / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use
D015032:Zinc
Zinkmangelsyndrom während kompletter parenteraler Langzeiternährung bei Morbus Crohn und Lebercirrhose Kasuistik und Zink-Pharmakokinetik.