Sandström B, Cederblad A, Lindblad B S, Lönnerdal B
Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.
Arch Pediatr Adolesc Med. 1994 Sep;148(9):980-5. doi: 10.1001/archpedi.1994.02170090094017.
To study zinc metabolism, copper status, and immune function in a patient with acrodermatitis enteropathica.
Case report.
A 16-year-old boy with acrodermatitis enteropathica.
Change of zinc supplementation dosage from 1000 to 525 mumol/d.
Zinc metabolism was studied with an oral dose of zinc chloride Zn 65 and whole-body counting at both zinc dosages. Zinc, copper status, and immune indexes were also measured at both dosages. The higher dosage of zinc supplementation was found to induce a state of low copper status and immune dysfunction. Lowering the dosage normalized these indexes. Zinc absorption in this patient was found to be within the reference range for healthy subjects. At the lower dosage, zinc retention and the rate of whole-body turnover also normalized. These results suggest that the primary lesion in acrodermatitis enteropathica is a cellular defect in zinc metabolism rather than an impairment of zinc absorption.
Zinc and copper status and immune function should be monitored regularly in patients with acrodermatitis enteropathica to provide a proper dosage of zinc during different physiologic stages.
研究肠病性肢端皮炎患者的锌代谢、铜状态及免疫功能。
病例报告。
一名16岁患肠病性肢端皮炎的男孩。
将锌补充剂量从1000 μmol/d 降至525 μmol/d。
通过口服氯化锌Zn 65并在两种锌剂量下进行全身计数来研究锌代谢。在两种剂量下还测量了锌、铜状态及免疫指标。发现较高剂量的锌补充会导致低铜状态和免疫功能障碍。降低剂量后这些指标恢复正常。该患者的锌吸收在健康受试者的参考范围内。在较低剂量时，锌潴留及全身周转率也恢复正常。这些结果表明，肠病性肢端皮炎的主要病变是锌代谢的细胞缺陷，而非锌吸收受损。
应定期监测肠病性肢端皮炎患者的锌、铜状态及免疫功能，以便在不同生理阶段提供合适的锌剂量。
