First full blown syndrome of acute zinc deficiency in course of long term total parenteral nutrition: a clinical case.

The case of a surgical patient with a full blown syndrome of zinc deficiency is presented and the various implications related to a deficiency of this trace mineral are discussed. The symptomatology involved mental depression, visual disturbances, glucose intolerance, decreased serum alkaline phosphatase levels, wound healing impairment, eczematoid dermatitis and reduced humoral and cellular immune defences. Oral supplementation with zinc sulphate dramatically reversed the signs and symptoms of the syndrome and resulted in rapid wound healing. This case seems to have exhibited most of the different signs and symptoms reported from time to time in the literature. Awareness of zinc deficiency is being brought to light in many medical and surgical conditions. Total parenteral nutrition (T.P.N.) can exacerbate the lack of this trace metal and supplementation with fresh blood derivate are, as demonstrated, useless in these cases. Zinc, as component of various metalloenzymes, accounts for the clinical manifestations of its deficiency.