ACRODERMATITIS-ENTEROPATHICA, ZINC-METABOLISM, COPPER STATUS, AND IMMUNE FUNCTION

Objective: To study zinc metabolism, copper status, and immune function in a patient with acrodermatitis enteropathica. Research Design: Case report. Patient: A 16-year-old boy with acrodermatitis enteropathica. Intervention: Change of zinc supplementation dosage from 1000 to 525 mu mol/d. Measurements and Results: 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. Conclusion: 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.