[Diagnosis and therapy of the zinc deficiency syndrome during total parenteral feeding. Review with report of a case].

A 47-year-old man with ulcerative colitis developed severe zinc deficiency during longterm intravenous feeding. Early symptoms included seborrhoeic lesions in the face and scalp. Later on his general condition deteriorated, and erythema and bullae erupted in the fingers, together with an erosive area with a marked border in the perianeal and scrotal regions. The symptomatology was suggestive of zinc depletion syndrome, a recently recognised acrodermatitis-enteropathica-like disorder in patients receiving longterm total intravenous feeding. A significantly lowered serum zinc level and a prompt beneficial response to intravenous zinc therapy (20 mg Zn2+ daily for one week) substantiate the provisional clinical diagnosis. As zinc depletion is caused by a zinc free parenteral alimentation this serious complication should be avoided by adding zinc to the infusions. Serum zinc determinations should be carried out as a control of the prophylactic zinc supply. Possibly, zinc plays a role in the symptomatology of various disorders with skin and bowel symptoms.