Oral zinc supplements in non-responsive coeliac syndrome: effect on jejunal morphology, enterocyte production, and brush border disaccharidase activities.

Three patients with clinically mild non-responsive adult coeliac syndrome were treated for eight weeks with oral zinc sulphate, and detailed biochemical and morphological studies were performed on the jejunal mucosa before and on treatment. Plasma zinc levels were reduced before treatment and rose to normal levels with therapy; mucosal zinc was normal before treatment and increased after therapy. Oral zinc supplementation did not alter the villous morphology, intraepithelial lymphocyte count or in vitro enterocyte production rate. In addition, there was no improvement in the clinical status of the patients. There was, however, a small increase in the activity of certain of the brush border disaccharidases. This effect may be due to direct stabilisation of the brush border membrane. The clinical value of zinc supplements in coeliac syndrome remains to be determined.