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一名母乳喂养婴儿出现短暂性症状性锌缺乏,与母体血清和母乳中锌水平低有关,补锌后情况改善:一种不常见的表型?

Transient Symptomatic Zinc Deficiency in a Breastfed Infant Associated with Low Zinc Levels in Maternal Serum and Breast Milk Improving after Zinc Supplementation: An Uncommon Phenotype?

作者信息

Vashist Sanket, Rana Ashwani, Mahajan Vikram K

机构信息

Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, (Tanda), Himachal Pradesh, India.

出版信息

Indian Dermatol Online J. 2020 Jan 24;11(4):623-626. doi: 10.4103/idoj.IDOJ_386_19. eCollection 2020 Jul-Aug.

Abstract

Acrodermatitis enteropathica (AE) is a rare, autosomal-recessive disorder of neonatal zinc deficiency due to (intestinal zinc transporter, Zip4) gene mutation with onset after weaning while breastfeeding during this period will be protective. Transient symptomatic zinc deficiency is also acquired rarely in breastfed infants with increased zinc requirements and/or inadequate concentration of zinc in breast milk. The nursing mothers of transient symptomatic zinc deficiency infants show (mammary epithelial zinc transporter, ZnT-2) gene mutation and abnormally low zinc levels in the breast milk despite normal serum zinc levels, which do not improve after zinc supplementation. A 2-month-old breastfed male infant had AE-like clinical features of zinc deficiency for two weeks. His symptoms and low serum zinc levels improved rapidly after zinc supplementation. The mother also had low serum and breast milk zinc concentration and both improved after oral zinc therapy indicating a non-heritable phenotype. The relevant literature is reviewed and significance of dietary zinc supplementation during pregnancy/lactation is emphasized.

摘要

肠病性肢端皮炎(AE)是一种罕见的常染色体隐性疾病,由(肠道锌转运体,Zip4)基因突变导致新生儿锌缺乏,断奶后发病,而在此期间母乳喂养具有保护作用。患有短暂性症状性锌缺乏的母乳喂养婴儿也很少见,这些婴儿锌需求量增加和/或母乳中锌浓度不足。短暂性症状性锌缺乏婴儿的哺乳母亲表现出(乳腺上皮锌转运体,ZnT-2)基因突变,尽管血清锌水平正常,但母乳中锌水平异常低,补充锌后也无改善。一名2个月大的母乳喂养男婴出现了两周类似AE的锌缺乏临床特征。补充锌后,他的症状和低血清锌水平迅速改善。母亲的血清和母乳锌浓度也较低,口服锌治疗后两者均有所改善,表明这是一种非遗传性表型。本文对相关文献进行了综述,并强调了孕期/哺乳期补充膳食锌的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac4/7413470/7234f5270aa7/IDOJ-11-623-g001.jpg

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