Zinc deficiency in an exclusively breast-fed preterm infant.
A formerly premature, exclusively breast-fed infant with severe zinc deficiency syndrome is presented. He showed the characteristic erosive skin changes, including alopecia, as seen in acrodermatitis enteropathica. In addition, he manifested a failure to thrive and irritability. The diagnosis was confirmed by reduced serum levels of zinc (2.3 mumol/l) and alkaline phosphatase (45 U/l). We consider the reduced zinc supply in the breast milk (5.7 mumol/l) as the most likely cause of the disease. Therapy consisted of oral zinc supplements (50 mumol/kg/day) for a period of 30 weeks. Symptoms and laboratory values normalized completely and did not recur on a normal diet.


CONCLUSIONS
A diet of breast milk can, in rare circumstances, cause insufficient zinc intake resulting in severe zinc deficiency syndrome with characteristic dermatological features. Therapy consists of temporary oral zinc supplementation at a daily dose of 50 mumol/kg.
Heinen
F
F
Universitäts-Kinderklinik Freiburg, Germany.
Matern
D
D
Pringsheim
W
W
Leititis
J U
JU
Brandis
M
M
D000469:Alkaline Phosphatase / Q000097:blood; D001942:Breast Feeding; D005183:Failure to Thrive / Q000097:blood / Q000209:etiology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012871:Skin Diseases / Q000097:blood / Q000209:etiology* / Q000628:therapy; D015032:Zinc / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D000469:Alkaline Phosphatase; D015032:Zinc