Acquired acrodermatitis enteropathica after gastric bypass surgery responsive to IV supplementation.
Nutritional deficiency is rare in developed countries, but can be acquired from decreased nutrient intake, reduced absorption, and increased gastrointestinal excretion. We report a patient with acquired acrodermatitis enteropathica (AE) who exhibited low plasma zinc levels and concurrent nutritional deficiencies (pyridoxine, selenium and fatty acids). Our patient had undergone Roux-en-Y gastric bypass 13 years prior to presentation. The rash, consistent with AE clinically and histologically, nearly resolved one week after starting IV zinc supplementation, total parenteral nutrition, and micronutrient supplements. This case highlights the importance of long-term post-operative follow-up for gastric bypass patients who are at high risk for micronutrient and macronutrient deficiencies and illustrates the potential for rapid improvement with IV supplementation.
Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Jasmine
J
Rana
Molly
M
Plovanich
Elizabeth B
EB
Wallace
Chao
C
Yang
Alvaro Laga
AL
Canales
Arash
A
Mostaghimi
D000169:Acrodermatitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D061605:Administration, Intravenous; D000328:Adult; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis* / Q000628:therapy; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014131:Trace Elements / Q000627:therapeutic use; D015032:Zinc / Q000172:deficiency* / Q000627:therapeutic use
D014131:Trace Elements; D015032:Zinc