Abstract

JUNQUERA BANARES, Sonia; ORIA MUNDIN, Eugenio  and  BOTELLA-CARRETERO, José Ignacio. Enteropathic acrodermatitis in a patient with high-out-put ileostomy. Nutr. Hosp. [online]. 2014, vol.29, n.2, pp.452-455. ISSN 1699-5198.  https://dx.doi.org/10.3305/nh.2014.29.2.7136.

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.

Keywords : High-output ileostomy; Enteropathic acrodermatitis; Zinc.

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