title: Zinc deficiency and toxicity in pediatric practice.
abstract: OBJECTIVE
  Zinc is a commonly overlooked deficiency in developed countries, occurring in infants, children, and adolescents during critical growth periods. The purpose of this review is to present the evidence of zinc deficiencies and toxicities as well as treatment in pediatrics.
  
  
  RESULTS
  During the last decade, the significance of zinc deficiency in childhood growth, morbidity, and mortality has been recognized by a number of large-scale supplementation trials in underdeveloped countries. Recognition of the recent nationwide shortage of injectable zinc available for total parenteral nutrition supplementation over the last 2 years focused attention on the possibility of zinc deficiency in the United States.
  
  
  CONCLUSIONS
  Although primarily thought of as a problem reserved for underdeveloped countries, zinc deficiency has increasing pediatric prevalence in the USA. Zinc is an essential trace element in the body that is responsible for numerous structural, catalytic, and biochemical functions. Deficiencies can occur because of poor dietary intake, long-term parenteral nutrition without supplementation, and enteral causes such as malabsorption. Zinc deficiency is closely associated with stunting, respiratory infections, diarrhea, and dermatitis. Deficiency is hard to define solely by the serum levels. Clinicians should utilize a combination of serum zinc levels, presenting signs and symptoms, and nutritional intake via oral, enteral, and parenteral routes to accurately assess the deficiency risk and diagnosis.
authors.affiliation: Department of Pediatric Nutrition Support, Cleveland Clinic Children's, Cleveland, OH, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Willoughby
authors.forename: Christine N
authors.initials: CN
authors.lastname: Bowen
mesh_terms: D000169:Acrodermatitis / Q000178:diet therapy* / Q000209:etiology / Q000276:immunology; D000293:Adolescent; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000178:diet therapy* / Q000209:etiology / Q000276:immunology; D014676:Diet, Vegetarian; D019587:Dietary Supplements; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D044342:Malnutrition / Q000150:complications / Q000178:diet therapy* / Q000276:immunology; D010288:Parenteral Nutrition; D014481:United States; D015032:Zinc / Q000172:deficiency* / Q000506:poisoning* / Q000627:therapeutic use
chemical_list: D015032:Zinc