scholarly journals Dysgeusia Due to Zinc Deficiency After Pancreaticoduodenectomy Requiring Continuous Intravenous Zinc Supplementation: a Case Report and Literature Review

Author(s):  
Hironobu Hata ◽  
Yojiro Ota ◽  
Katsuhiko Uesaka ◽  
Yutaka Yamazaki ◽  
Tsubasa Murata ◽  
...  

Abstract Background: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies regarding the development of zinc deficiency after PD and presented the case of a patient with zinc deficiency after PD, who required home intravenous zinc replacement.Case presentation: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously under readmission. Her serum zinc levels recovered, and the lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.Conclusion: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of dysgeusia associated with zinc deficiency after cancer surgery, as well as that induced by chemotherapy or head and neck radiation therapy.

2019 ◽  
Vol 32 (10) ◽  
pp. 1083-1087 ◽  
Author(s):  
Kei Yoshida ◽  
Tatsuhiko Urakami ◽  
Remi Kuwabara ◽  
Ichiro Morioka

Abstract Background and methods We investigated the frequency of zinc deficiency in Japanese children with idiopathic short stature, and evaluated whether serum zinc levels correlated with background factors, including age and standard deviation scores (SDSs) for height and serum insulin-like growth factor (IGF)-1 levels. The study subjects consisted of 89 Japanese children. Results The mean serum zinc level was 79 ± 12 (49–108) μg/dL. Of all the children, 48.3% had a low zinc level, in the 60–80 μg/dL range, and 6.7% had zinc deficiency with a zinc level below 60 μg/dL. The majority with a low zinc level and zinc deficiency were asymptomatic other than for short stature. We found no significant correlations of serum zinc with age, or the SDSs for height and serum IGF-1 levels, in either the entire subject population or those with a zinc level below 80 μg/dL. Conclusions We found a low zinc level to be common in Japanese children with idiopathic short stature, whereas actual zinc deficiency was rare. However, other as yet unknown mechanisms not associated with the growth hormone (GH)-IGF-1 axis could be involved in growth retardation in idiopathic short stature.


Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 764 ◽  
Author(s):  
Satoshi Shimizu ◽  
Ritsukou Tei ◽  
Masahiro Okamura ◽  
Nobuteru Takao ◽  
Yoshihiro Nakamura ◽  
...  

Background: It is known that patients on hemodialysis (HD) are prone to developing zinc deficiency due to removal of zinc by HD, inadequate dietary intake, and reduced gastrointestinal zinc absorption. However, the prevalence of zinc deficiency in patients on peritoneal dialysis (PD) has not been well established. Methods: Serum zinc levels were compared between 47 patients on PD and 47 patients on HD matched for age, sex, and duration of dialysis. A serum zinc level < 60 μg/dL was defined as clinical zinc deficiency and a level of 60–80 μg/dL as subclinical zinc deficiency. The prevalence of zinc deficiency and associated clinical factors were determined in both groups. Results: Clinical zinc deficiency was found in 59.6% of the PD group and 70.2% of the HD group (p = 0.391). Subclinical zinc deficiency was found in 40.4% of the PD group and 29.8% of the HD group. Age, body mass index, and serum albumin level were identified as independent predictors of zinc deficiency in the PD group by multivariate analysis. Conclusions: A higher prevalence of clinical and subclinical zinc deficiency was found in patients on PD. The rates were comparable between patients on PD and those on HD after adjustment for confounding factors.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yumika Seki ◽  
Kota Ishizawa ◽  
Tetsuya Akaishi ◽  
Michiaki Abe ◽  
Koji Okamoto ◽  
...  

Abstract Background Zinc is an essential micronutrient for maintaining biological activity. The level of zinc in the blood is known to decrease with age, especially in those over 75 years of age. In older adults patients with impaired functional status, aspiration pneumonia based on dysphagia often becomes problematic. However, the relationship between zinc deficiency and swallowing function has not been studied before. Methods A total of 52 older adults subjects (15 males and 37 females) living in a nursing home were enrolled for this study. At the time of enrollment, data of gender, age, body weight, serum zinc levels, serum albumin levels, and the time in a simple 2-step swallowing provocation test (S-SPT) were collected. In patients with serum zinc levels < 60 μg/dL, we initiated 2 months of oral zinc supplementation therapy with a 34 mg/day zinc load. Those who underwent zinc supplementation were re-evaluated after the treatment period and serum zinc levels and S-SPT time were measured. Results At the time of enrollment, serum zinc level was significantly correlated with serum albumin levels (Pearson’s R = 0.58, p < 0.0001) and time in the S-SPT (Spearman’s rho = − 0.32, p = 0.0219). Twenty-five of the 52 patients had zinc deficiency with a serum zinc level < 60 μg/dL. After 2 months of oral zinc supplementation, both serum zinc levels (p < 0.0001) and time in the S-SPT (p = 0.04) significantly improved. Meanwhile, serum albumin level (p = 0.48) or body weight (p = 0.07) did not significantly change following zinc supplementation. Zinc supplementation significantly improved swallowing function, especially in the older adults who had comorbid dysphagia and zinc deficiency. Conclusions Zinc deficiency is associated with compromised swallowing function in older adults patients with impaired general functions. Oral zinc supplementation can alleviate dysphagia in older adults patients with zinc deficiency even though this is a retrospective study. Further study will be needed to confirm this positive effect.


2018 ◽  
Vol 25 (02) ◽  
pp. 307-312
Author(s):  
Thiga Mohammed Mohammed Osman Alhassan ◽  
Abdelmula Mohamed Abdalla ◽  
Eshtiag Mohammed Mohammed Osman Alhassan ◽  
Suhair Abdelrahman Ahmed

Back ground: Acne vulgaris is a common chronic inflammatory disease ofthe skin. Zinc is a trace element, exists in high amounts within the skin and especially theepidermis. Its importance for human metabolism has been noted by the dramatic improvementof acrodermatitis enteropathica following zinc supplementation. Objectives: To evaluate theserum zinc level among patients with acne vulgaris, and to correlate age, grade and durationof acne vulgaris with serum zinc level. Study Design: Case- control hospital base study.Setting: Khartoum state at Khartoum Dermatology & Venerology Hospital. Period: February toSeptember 2017. Materials Methods: 100 samples were collected from patients attending toKhartoum Dermatology & Venerology hospital suffering from acne vulgaris. Acne severity wasclassified according to Global Acne Grading System (GAGS). In addition to other 100 samplescollected from healthy individuals (students and nurse) sex and age matched as control. Thelevels of serum zinc was measured in each group by atomic absorption spectroscopy. Results:The study showed significant decrease in the zinc concentrations in acne vulgaris patientswhen compared with the reference group (0.207±0.04 mg/l versus 0.788 ± 0.14 mg/l) (p=0.000). The study observed decreased serum zinc level with advancedgrade of acne; mild47 patients (47%) (0.247 ± 0.05), moderate 33 (33%) (0.1925 ± 0.04) and severe in 20 (20%)(0.180 ± 0.03), based on the anova test analysis mean serum zinc levels were significantlylower in patients with mild to moderate and to severe acne vulgaris when compared betweenacne vulgairs grades and with reference group(p ≤ 0.001, p ≤ 0.01, p ≤ 0.05 respectively).The present study showed no correlation between zinc level (mg/l) and age in patient with acnevulgaris (years) (r=0.032, P =0.827). On the other hand significant correlation was recordedbetween serum zinc level (mg/l) and duration of the acne vulgaris in the study group (r=-0.311,p = 0.028). Conclusion: Study revealed that serum zinc levels is significantly decreased inpatients with acne vulgaris, and prescribing zinc supplement treatments help increasing thesuccess rate of acne treatment.


2020 ◽  
Author(s):  
Yumika Seki ◽  
Kota Ishizawa ◽  
Tetsuya Akaishi ◽  
Michiaki Abe ◽  
Okamoto Koji ◽  
...  

Abstract Background: Zinc is an essential micronutrient for maintaining biological activity. The level of zinc in the blood is known to decrease with age, especially in those over 75 years of age. In elderly patients with impaired functional status, aspiration pneumonia based on dysphagia often becomes problematic. However, the relationship between zinc deficiency and swallowing function has not been studied before.Methods: A total of 52 elderly subjects (15 males and 37 females) living in a nursing home were enrolled for this study. At the time of enrollment, data of gender, age, body weight, serum zinc levels, serum albumin levels, and the time in a simple 2-step swallowing provocation test (S-SPT) were collected. In patients with serum zinc levels < 60 μg/dL, we initiated 2 months of oral zinc supplementation therapy with a 34 mg/day zinc load. Those who underwent zinc supplementation were re-evaluated after the treatment period and serum zinc levels and S-SPT time were measured.Results: At the time of enrollment, serum zinc level was significantly correlated with serum albumin levels (Pearson’s R = 0.58, p < 0.0001) and time in the S-SPT (Spearman’s rho = -0.32, p = 0.0219). Twenty-five of the 52 patients had zinc deficiency with a serum zinc level < 60 μg/dL. After 2 months of oral zinc supplementation, both serum zinc levels (p < 0.0001) and time in the S-SPT (p = 0.04) significantly improved. Meanwhile, serum albumin level (p = 0.48) or body weight (p = 0.07) did not significantly change following zinc supplementation. Zinc supplementation significantly improved swallowing function, especially in the elderly who had comorbid dysphagia and zinc deficiency.Conclusions: Zinc deficiency is associated with compromised swallowing function in elderly patients with impaired general functions. Oral zinc supplementation can alleviate dysphagia in elderly patients with zinc deficiency.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2077
Author(s):  
Jiun-Chi Huang ◽  
Ya-Chin Huang ◽  
Pei-Yu Wu ◽  
Wen-Hsien Lee ◽  
Yi-Chun Tsai ◽  
...  

Diastolic dysfunction is an emerging challenge among hemodialysis (HD) patients, and the associations between serum zinc with echocardiographic parameters and diastolic function remain uncertain. A total of 185 maintenance HD patients were stratified by the tertiles of serum zinc level to compare their clinical characteristics and echocardiography. Correlations of serum zinc levels with echocardiographic parameters were examined using Pearson’s analysis. Univariate and multivariate logistic regression analyses were performed to investigate the determinants of E/e’ ratio >15 and left atrial volume index (LAVI) > 34 mL/m2, both indicators of diastolic dysfunction. Patients belonging to the first tertile of serum zinc level had a significantly higher E/e’ ratio and LAVI. Serum zinc levels were negatively correlated with E (r = −0.204, p = 0.005), E/e’ ratio (r = −0.217, p = 0.003), and LAVI (r = −0.197, p = 0.007). In a multivariate analysis, older age, diabetes, coronary artery disease, and lower serum zinc levels (OR = 0.974, 95% CI = 0.950–0.999, p = 0.039) were significantly associated with E/e’ ratio >15. Furthermore, diabetes and lower serum zinc levels (OR = 0.978, 95% CI = 0.958–0.999, p = 0.041) were significantly associated with LAVI >34 mL/m2. Reduced serum zinc level was significantly associated with diastolic dysfunction among HD patients. Further prospective studies are warranted to investigate whether zinc supplementation can attenuate cardiac dysfunction in maintenance HD patients.


2020 ◽  
Vol 7 (47) ◽  
pp. 2777-2782
Author(s):  
Mohan Rao Munnaluri ◽  
Sravan Chittla ◽  
Nihal Perumalla

BACKGROUND Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit which occurs in adolescent age groups. Physical and psychological scars can create social issues in the family, school and workplace. The disorder is multifactorial. There are plenty of recovery choices but are not satisfactory. We wanted to investigate the serum zinc levels and the therapeutic utility of oral zinc supplementation in acne vulgaris patients. METHODS This is a prospective study conducted over a period of one and a half years among one hundred acne patients who reported to the outpatient clinic of the Department of Dermatology, Venereology and Leprology with untreated patients of acne vulgaris. RESULTS Males were 65 % and females were 35 % with male : female ratio of 6.5 : 3.5. Most of the patients were students occupying 71 % of the study. Family history was observed in 46 % of patients, either in the siblings or in the parents. Premenstrual flare-up of acne lesions was noted in 71.42 % of female patients indicating a pivotal role of hormones in the pathogenesis of acne. Aggravation of lesions in summer was noted in 45 % of patients. Aggravation of acne lesions with different types of diet like non-vegetarian food, oily food and chocolates was noticed in 69 % of the study. History of usage of different types of cosmetics available in the market was noted in 76 % of the patients. In the present study, 62 % had lower than normal serum zinc levels and 38 % had normal serum zinc levels. Thus, serum zinc levels were found to be lower in both male and female acne patients in the majority (62 %) of the study patients and also normal healthy controls. The fasting serum zinc levels in the 62 patients before and after oral zinc sulphate were estimated after completion of 3 months treatment. Normal serum zinc levels were observed in all 62 patients treated. CONCLUSIONS Oral zinc sulphate is an effective, safe and economic remedy in the treatment of acne vulgaris. The extra advantage with oral zinc sulphate is that it is devoid of many adverse reactions commonly seen after prolonged use of systemic antibiotics. KEYWORDS Oral Zinc Sulphate, Acne Vulgaris


2020 ◽  
Vol 7 (3) ◽  
pp. 588
Author(s):  
Madhubalan T. ◽  
Chidambaranathan S. ◽  
Ramamoorthy R.

Background: A seizure is a paroxysmal time-limited change in motor activity and or behavior that results from abnormal electrical activity in the brain. Seizures are common in the pediatric age group and occur in approximately 10% of children. Most seizures in children are provoked by somatic disorders originating outside the brain such as high fever, infection, syncope, head trauma, hypoxia, or toxins. To determine whether children with febrile convulsion have decreased serum zinc level when compared to normal children and children with fever without convulsions.Methods: The study included children admitted with bronchiolitis in between during the period of September 2018 to January 2019 at Department of Pediatrics, Raja Muthiah Medical College and Hospital. It is a case-control study. A sample size of 50 was selected for each group Totally 3 Groups, 1. Children with febrile convulsions,2. Children with fever without convulsions, 3. Normal Children.Results: The mean serum zinc level in children with febrile convulsions was 42.9 mcg/dl. The serum zinc level in children with fever and normal children was 70 mcg/dl and 71 mcg/dl respectively. On comparing the serum zinc level among the three groups statistical significance was obtained between children with febrile convulsions and the other two groups namely normal children and children with fever alone. Thus, decreased serum zinc level is a significant predisposing factor for febrile convulsions. By using Posthoc Multiple comparisons test we came to know that the Fever convulsion group is significantly different from fever and normal group. There is no significant difference between fever and normal group.Conclusions: This study shows that serum zinc levels are decreased in children with febrile convulsions, thus indicating that zinc deprivation plays a significant role in the pathogenesis of febrile convulsions.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Satoshi Matsui ◽  
Tomonaga Ameku ◽  
Daisuke Takada ◽  
Shinji Ono

Abstract Background Hypozincemia contributes to phosphate-induced vascular calcification in model animals of renal failure, but the association between hypozincemia and aortic stenosis (AS) prevalence in patients with end-stage kidney disease remains unreported in clinical settings. Methods To investigate the association between hypozincemia and AS prevalence in patients undergoing hemodialysis, we designed a single-center cross-sectional study. Our outcome “AS” was defined as prevalence of moderate or severe AS or surgical history for AS. Depending on serum zinc levels, we divided patients undergoing hemodialysis into deciles. The association between hypozincemia and AS prevalence was analyzed via logistic regression adjusted for age, sex, dialysis vintage, diabetes history, serum albumin, and history of taking calcium-containing phosphate binder. Results Ninety-three patients undergoing hemodialysis were eligible. The mean serum zinc level was 61.3 ± 13.9 μg/dL. Twelve patients who belonged to 1st decile had serum zinc levels ≤ 48 μg/dL. Of these twelve patients, six patients (50 %) had AS. On the other hand, of eighty one patients who belonged to 2nd–10th deciles (serum zinc levels > 48 μg/dL), thirteen patients (16 %) had AS. Hypozincemia (serum zinc levels ≤ 48 μg/dL) was associated with AS prevalence (P = 0.038; odds ratio 4.43; 95% confidence interval 1.09–18.0). Conclusions AS was more prevalent in patients undergoing hemodialysis with severe hypozincemia in our cross-sectional study, although interventional studies are required to elucidate the benefit of zinc supplementation for AS progression.


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