title: [Enteropathic acrodermatitis in a patient with high-out-put ileostomy].
abstract: Zinc deficiency is relatively common in certain pathologies, although its clinical manifestation is uncommon. We present the case of a patient who was admitted presenting hyponatremic dehydration and pre-renal failure secondary to high-output ileostomy and oral intolerance. Although the ileostomy output was normalized within 3 days of admission and initial zinc plasma levels were normal, after being fed with TPN supplemented with 13 mg/day of zinc, he suffered a severe zinc deficit with enteropathic acrodermatitis that was completely resolved after one week with 26.5 mg/day. However, plasma levels did not return to normal until one month on therapy with high doses of zinc. Zinc plasma levels are not a good indicator of zinc stores in the body and many times their changes are a late indicator of zinc deficit. There is not a correlation between the clinical improvement and normalization of zinc levels, being common the clinical resolution within few days of the supplementation without observing an increase of zinc plasma levels.
authors: Servicio de Endocrinología y Nutrición. Hospital de Navarra.. sojuba@hotmail.com.
authors: Sonia
authors: S
authors: Junquera Bañares
authors: Servicio de Endocrinología y Nutrición. Hospital de Navarra.. sojuba@hotmail.com.
authors: Eugenio
authors: E
authors: Oria Mundín
authors: Servicio de Endocrinología y Nutrición. Hopital Ramón y Cajal. Madrid. España.. sojuba@hotmail.com.
authors: José Ignacio
authors: JI
authors: Botella-Carretero
mesh_terms: D000169:Acrodermatitis / Q000209:etiology*; D000328:Adult; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D008297:Male; D015032:Zinc / Q000097:blood / Q000172:deficiency
chemical_list: D015032:Zinc