ALCOHOLIC PANCREATITIS - PATIENTS AT HIGH-RISK OF ACUTE ZINC-DEFICIENCY

The important role of zinc as an essential nutrient and therapeutic agent has been increasingly recognized in the last two decades. Abnormalities in physical growth and sexual maturation are caused by zinc deficiency. More recently, several clinical observations have suggested an association between zinc deficiency and poor healing of wounds, anorexia, hypogeusia and behavioral disorders. Furthermore, zinc-responsive vesiculobullous dermatitis has been well described. Within a seven-month period, we have seen two patients with alcoholic pancreatitis in whom acute zinc deficiency developed in the course of their treatment with parenteral hyperalimentation. Clinically, the zinc deficiency was manifested by the appearance of an erythematous, desquamative rash on the face. Serum zinc levels were remarkably low in each patient at the time the skin rash appeared: 18 and 11 μg/dl. Upon treatment with one or two tablets of zinc sulfate per day (220 mg each), the skin rashes rapidly and completely resolved within one to two weeks. Serum zinc levels were 49 and 50 μg/dl at the time the rash disappeared. Alcoholics, when subjected to stress, appear to be a high-risk group for the development of severe zinc deficiency while undergoing parenteral nutrition. Several factors which contribute to the development of zinc deficiency in alcoholics include diminished dietary intake, enhanced urinary excretion of zinc and, probably, marked diminution in zinc absorption. It is recommended that zinc supplementation be included as a standard part of total parenteral nutrition in this patient group. © 1979.