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Clinical and laboratory diagnosis of acrodermatitis enteropathica

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Abstract

Acrodermatitis enteropathica is an inborn error of metabolism resulting in zine malabsorption and severe zinc deficiency. From personal experience and a literature review the following conclusions were drawn: 1. Symptoms other than dermatitis, vary with age. Diarrhoea, mood changes, anorexia, and neurological disturbance were reported most frequently in infancy. Growth retardation, alopecia, weight loss and recurrent infections were prevalent in toddlers and schoolchildren. Spontaneous remission may occur at adolescence. 2. The severity of symptoms also varies. Intermittent or mild cases of the disease and those presenting with uncommon features such as ophthalmic, cerebral or hepatic involvement, are easily overlooked. In the severe cases this may result in a fatal outcome. If untreated, the overall mortality rate is 20%, being higher in males. 3. The laboratory diagnosis is hazardous. In patients, mean zine values in serum, urine and hair were ca. 50% of normal levels. There is a 15% overlap with healthy controls; moreover, low zine levels in serum, urine or hair are also found in other diseases. A more specific test is required. 4. In cases of doubt, in vitro or in vivo zine absorption tests using radioisotopes (65Zn or69mZn) may be performed. These appear not to be influenced by other conditions and show less overlap with controls. If such tests are unavailable, the clinical response to 3–30 μmol zinc/kg per day for 5 days may be awaited. This is recommended in infants or children with one or more symptoms of acrodermatitis enteropathica.

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References

  1. Aggett PJ, Delves HT, Harries JT, Bangham AD (1979) The possible role of diodoquin as a zine ionophore in the treatment of acrodermatitis enteropathica. Biochem Biophys Res Commun 87:513–517

    PubMed  Google Scholar 

  2. Aggett PJ, Delves HT, Thorn JM, Atherton DJ, Harries JT, Bangham AD (1981) The therapeutic effect of amphotericin in acrodermatitis enteropathica: hypothesis and implications. Eur J Pediatr 137:23–25

    PubMed  Google Scholar 

  3. Aksu F, Huck W, Sperling G, Mietens C (1980) Acrodermatitis Enteropathica: heute eine behandelbare Krankheit. Med Klin 75:485–489

    PubMed  Google Scholar 

  4. Amador M, Peña M, Garcia-Miranda A, Gonzalez A, Hermelo M (1975) Low hairzinc concentrations in acrodermatitis enteropathica. Lancet I:1379

    Google Scholar 

  5. Anonymous (1981) Zinc therapy of depressed cellular immunity in acrodermatitis enteropathica. Nutr Rev 39:168–170

    Google Scholar 

  6. Anttila PH, Simell O, Salmela S, Vuori E (1984) Serum and hair zine as predictors of clinical symptoms in acrodermatitis enteropathica. J Inherited Metab Dis 7:46–48

    PubMed  Google Scholar 

  7. Anttila PH, Von Willebrand E, Simell O (1986) Abnormal immune responses during hypozincaemia in acrodermatitis enteropathica. Acta Paediatr Scand 75:988–992

    PubMed  Google Scholar 

  8. Atherton DJ, Muller DPR, Aggett PJ, Harries JT (1979) A defect in zine uptake by jejunal biopsies in acrodermatitis enteropathica. Clin Sci 56:505–507

    PubMed  Google Scholar 

  9. Ayala F, Santoianni P (1978) Nota Sul Trattamento della Acrodermatite Enteropatica con Sulfato di Zinco. Giorn e Min Derm 113:881–884

    Google Scholar 

  10. Berfenstam R (1952) Studies on blood zine. Acta Paediatr Scand [Suppl] 41:87:37

    Google Scholar 

  11. Bloom D (1960) Acrodermatitis enteropathica: another inborn error of metabolism? Follow-up case reported in 1955 and review of the recent literature. NY State J Med 3609–3616

  12. Bohane TD, Cutz E, Hamilton JR, Gall DG (1977) Acrodermatitis enteropathica, zine and the paneth cell. Gastroenterology 73:587–592

    Google Scholar 

  13. Brandt T (1936) Dermatitis in children with disturbances of general condition and absorption of feed elements. Acta Derm Venereol (Stockh) 17:513–537

    Google Scholar 

  14. Braun OH, Heilmann K, Rossner JA, Pauli W, Bergmann KE (1977) Acrodermatitis enteropathica, ii zinc deficiency and ultrastructural findings. Eur J Pediatr 125:153–162

    PubMed  Google Scholar 

  15. Bronson DM, Barsky R, Barsky S (1983) Acrodermatitis enteropathica, recognition at long last during a recurrence in a pregnancy. J Am Acad Dermatol 9:140–144

    PubMed  Google Scholar 

  16. Businco L, Menghi AM, Rossi P, D'Amelio R, Galli E (1980) Zinc-dependant chemotactic defect in an intant with acrodermatitis. Arch Dis Child 55:966–968

    PubMed  Google Scholar 

  17. Cameron JD, NeCalin CJ (1986) Ocular histopathology of acrodermatitis enteropathica. Br J Ophthalmol 70:662–667

    PubMed  Google Scholar 

  18. Campo AG jr, McDonald J (1976) Treatment of acrodermatitis enteropathica with zinc sulfate. Arch Dermatol 112:687–689

    PubMed  Google Scholar 

  19. Casey CE, Hambidge KM, Walravens PA (1979) Zinc binding in human duodenal secretions. J Pediatr 95:1008–1010

    PubMed  Google Scholar 

  20. Cash R, Berger CK (1969) Acrodermatitis enteropathica: defective metabolism of unsaturated fatty acids. J Pediatr 74:717–729

    PubMed  Google Scholar 

  21. Chandra RK (1980) Acrodermatitis enteropathica: zinc levels and cell-mediated immunity. Pediatrics 66:789–791

    PubMed  Google Scholar 

  22. Chandra RK (1984) Excessive intake of zinc impairs immune responses. JAMA 252:1443–1446

    PubMed  Google Scholar 

  23. Crofton RW, Gvozdanovic S, Gvozdanovic S, Aggett PJ, Mowat NAG, Brunt PW (1983)65Zinc metabolism in coeliac disease. Proc Nutr Soc 42:112A

    Google Scholar 

  24. Cunnane SC, Krieger I (1988) Long chain fatty acids in serum phospholipids in acrodermatitis enteropathica before and after zinc treatment. J Am Coll Nutr 7:249–250

    PubMed  Google Scholar 

  25. Danbolt N, Closs K (1943) Akrodermatitis enteropathica. Acta Derm Venereol (Stockh) 23:128–143

    Google Scholar 

  26. Dérer M (1978) Acrodermatitis enteropathica-dedicná zinková deficiencia. Bratisl Lek Listy 69:583–588

    PubMed  Google Scholar 

  27. Dillaha CJ, Lorincz AL, Aavik OR (1953) Acrodermatitis enteropathica. JAMA 52:509–512

    Google Scholar 

  28. Domanasiewicz M, Wasik F, Zajac J (1978) Zincaczenie cynku w leczeniu acrodermatitis enteropathica. Pol Tyg Lek 33:1339–1340

    Google Scholar 

  29. Dupré A, Bonafé JL, Carriere JP (1979) The hair in acrodermatitis enteropathica — a disease indicator? Acta Derm Venereol (Stockh) 59:177–178

    Google Scholar 

  30. Endre L, Katona Z, Gyurkovits K (1975) Zinc deficiency and cellular immune deficiency in acrodermatitis enteropathica. Lancet I:1196

    Google Scholar 

  31. Fakhouri Z (1979) Acrodermatitis Enteropathica Danbolt-Closs Verlauf von zwei Fällen unter Zinksulfattherapie. Dermatol Monatsschr 165:131–132

    PubMed  Google Scholar 

  32. Feldberg R, Yassur Y, Ben-Sira I, Varsano I, Zelikovitz I (1981) Keratomalacia in acrodermatitis enteropathica. Metab Pediatr Ophthalmol 5:207–211

    PubMed  Google Scholar 

  33. Frank K, Földes Gy, Török E (1976) Acrodermatitis enteropathica and nerve damage. Lancet II:51

    Google Scholar 

  34. Galli E, Rossi P, Delle Femmine P, Vercillo P, Fiore L, Businco L (1983) Long-term follow-up of a child with acrodermatitis enteropathica treated with zinc. Immunol Clin Sper II, 1

  35. Garretts M, Molokhia M (1977) Acrodermatitis enteropathica without hypozincemia. J Pediatr 91:492–494

    PubMed  Google Scholar 

  36. Gartside JM, Allen BR (1975) Treatment of acrodermatitis enteropathica with zinc sulphate. Br Med J 3:521–522

    PubMed  Google Scholar 

  37. Glasgow JFT, Elmes EM (1975) Exacerbation of acrodermatitis enteropathica by soya-bean milk feeding. Lancet II:769

    Google Scholar 

  38. Gonzalez JR, Botet MV, Sanchez JL (1982) The histopathology of acrodermatitis enteropathica. Am J Dermatopathol 4:303–311

    PubMed  Google Scholar 

  39. Graves K, Kestenbaum T, Kalivas J (1980) Hereditary acrodermatitis enteropathica in an adult. Arch Dermatol 116:562–564

    PubMed  Google Scholar 

  40. Guiraldes E, Sorensen R, Guitierrez C, Cofre P, Gonzalez B (1975) Zinc sulphate for acrodermatitis enteropathica. Lancet II: 710–711

    Google Scholar 

  41. Hambidge KM (1980) Hair analyses. Pediatr Clin North Am 27: 855–859

    PubMed  Google Scholar 

  42. Hambidge KM, Neldner KH, Walravens PA, Weston WL, Silverman A, Sabol JL, Brown RM (1978) Zinc and acrodermatitis enteropathica. In: Hambidge KM, Nichols BL Jr (eds) Zinc and copper in clinical medicine. SP Med Science Books, New York, pp 81–98

    Google Scholar 

  43. Hansson O (1963) Acrodermatitis enteropathica, report of 2 cases and a hypothesis concerning pathogenesis of disease. Acta Derm Venereol (Stockh) 43:465–471

    Google Scholar 

  44. Hartz A (1984) Overlap index. Arch Pathol Lab Med 108:65–67

    PubMed  Google Scholar 

  45. Hawkins T, Marks JM, Plummer VM, Greaves MW (1976) Whole body monitoring and other studies of zinc-65 metabolism in patients with dermatological diseases. Clin Exp Dermatol I:243–249

    Google Scholar 

  46. Henkin RI, Aamodt RL (1975) Zinc absorption in acrodermatitis enteropathica and in hypogeusia and hyposmia. Lancet I: 1379–1380

    Google Scholar 

  47. Hira SK, Bhat GJ, Arora P (1983) Acrodermatitis enteropathica: a case report. Med J Zambia 17:61–63

    PubMed  Google Scholar 

  48. Hirsh FS (1976) Gluconate zinc in acrodermatitis enteropathica. Arch Dermatol 112:475–478

    PubMed  Google Scholar 

  49. Hoogenraad TU, Dekker AW, Van Den Hamer CJA (1985) Copper responsive anemia, induced by oral zine therapy in a patient with acrodermatitis enteropathica. Sci Total Environ 42:37–43

    PubMed  Google Scholar 

  50. Ialescon A, Perrone L (1985) Erythrocytic zinc content during childhood. Acta Haematol 73:114–116

    PubMed  Google Scholar 

  51. Ilic S, Lalevic B (1958) Contribution to the problem of acrodermatitis enteropathica. Dermatologica 117:317–325

    PubMed  Google Scholar 

  52. Ishibashi Y, Nakabayashi Y, Kukita A, Benno Y, Mitsuoka T (1985) Abnormalities of fecal flora in patients with acrodermatitis enteropathica. J Dermatol 12:219–225

    PubMed  Google Scholar 

  53. Iyengar V, Woittiez J (1988) Trace elements in human clinical specimens: evaluation of literature data to identify reference values. Clin Chem 34:474–481

    PubMed  Google Scholar 

  54. Jones RB, Keeling PWN, Hilton PJ, Thompson RPH (1981) Relationship between leucocyte and muscle zinc in health and disease. Clin Sci 60:237–239

    PubMed  Google Scholar 

  55. Jones JG, Elmes ME, Aggett PJ, Harries JT (1983) The effect of zinc therapy on lysosomal inclusion bodies in intestinal epithelial cells in acrodermatitis enteropathica. Pediatr Res 17:354–357

    PubMed  Google Scholar 

  56. Kaloustian V Der, Musallam SS, Sanjad SA, Murib AM, Hammad WD, Idriss ZH (1976) Oral treatment of acrodermatitis enteropathica with zinc sulfate. Am J Dis Child 130:421–423

    PubMed  Google Scholar 

  57. Koletzko B, Bretschneider A, Bremer HJ (1985) Fatty acid composition of plasma lipids in acrodermatitis enteropathica before and after zinc supplementation. Eur J Pediatr 143:310–314

    PubMed  Google Scholar 

  58. Krieger I, Evans GW (1980) Acrodermatitis enteropathica without hypozincemia: therapeutic effect of a pancreatic enzyme preparation due to a zinc binding ligand. J Pediatr 96:32–35

    PubMed  Google Scholar 

  59. Krieger I, Cash R, Evans GW (1984) Picolinic acid in acrodermatitis enteropathica. J Pediatr Gastroenterol Nutr 3:62–68

    PubMed  Google Scholar 

  60. Larregue M, Baudon J-J, Fontaine J-L, Feldmann G, Laplane R (1977) Acrodermatitis enteropathica, action thérapeutique du sulphate de zinc. Ann Derm Vénéréol (Paris) 104:737–744

    Google Scholar 

  61. Leupold D, Poley JR, Meigel WN (1976) Zinc therapy in acrodermatitis enteropathica. Helv Paediatr Acta 31:109–115

    PubMed  Google Scholar 

  62. Lombeck I (1980) The clinical significance of trace elements in childhood. In: Frick P, Harnack GA von, Martini GA, Prader A, Wolff HP (eds) Advances in internal medicine and pediatrics. Springer, Berlin Heidelberg New York, pp 7–13

    Google Scholar 

  63. Lombeck I, Bassewitz B von, Becker K, Tinschmann P, Kästner H (1974) Ultrastructural findings in acrodermatitis enteropathica. Pediatr Res 8:82–86

    PubMed  Google Scholar 

  64. Lombeck I, Schnippering HG, Ritzl F, Feinendegen FL, Bremer HJ (1975) Absorption of zinc in acrodermatitis enteropathica. Lancet I:855

    Google Scholar 

  65. Lombeck I, Schnippering HG, Kasparel K, Ritzl F, Kästner H, Feinendegen LE, Bremer HJ (1975) Acrodermatitis Enteropathica, eine Zinkstoffwechselstörung mit Zinkmalabsorption. Z Kinderheilkd 120:181–189

    PubMed  Google Scholar 

  66. Lungarotti MS, Rufini S, Calabro A, Mariotti G, Ghebregzabher M, Monaldi B (1976) Treatment of acrodermatitis enteropathica with zinc sulphate. Hely Paediatr Acta 31:117–120

    Google Scholar 

  67. Lynch WS, Roenigk HH Jr (1976) Acrodermatitis enteropathica, successful zinc therapy. Arch Dermatol 112:1304–1307

    PubMed  Google Scholar 

  68. Marandian M-H, Haghigat H, Youssefian H, Lessani M, Behvad A, Chams C (1978) Acrodermatitis enteropathica traitée par le sulfate de zinc. Arch Fr Pédiatr 35:870–874

    Google Scholar 

  69. Margileth CAM (1963) Acrodermatitis enteropathica, case report and review of the literature. Am J Dis Child 105:101–107

    Google Scholar 

  70. Matsuura S, Yasuoka C, Yamashita F (1984) Acrodermatitis enteropathica in breast-fed infant. Acta Paediatr Jpn 261:91–93

    Google Scholar 

  71. McKusick VA (1983) The Mendelian inheritance in man. The John Hopkins University Press, Baltimore, pp 578–579

    Google Scholar 

  72. Michaelsson G (1974) Zinc therapy in acrodermatitis enteropathica. Acta Derm Venereol (Stockh) 54:377–381

    Google Scholar 

  73. Mortimer PS, Gough P, Newbold PCH, Dawber RPR, Ryan TJ (1984) Acrodermatitis enteropathica. J R Soc Med 77:67–68

    PubMed  Google Scholar 

  74. Moynahan EJ (1973) Le Zinc et le poil dans l'acrodermatitis enteropathica. Bull Soc Fr Dermatol Syph 80:541–543

    Google Scholar 

  75. Moynahan EJ (1974) Acrodermatitis enteropathica: a lethal inherited human zinc-deficiency disorder. Lancet II:399–400

    Google Scholar 

  76. Moynahan EJ (1975) Zinc deficiency and cellular immune deficiency in acrodermatitis enteropathica in man and zinc deficiency with thymic aplasia in fresian calves: a possible genetic link. Lancet II:710

    Google Scholar 

  77. Moynahan EJ (1976) Zinc deficiency and disturbances of mood and visual behaviour. Lancet I:91

    Google Scholar 

  78. Naik RPC, Meera Baliga M (1981) Acrodermatitis enteropathica, case report. Indian J Dermatol Venereol Lepr 47:117–119

    Google Scholar 

  79. Naveh Y, Lightman A, Zinder O (1982) Effect of diarrhea on serum zinc concentrations in infants and children. J Pediatr 101:730–732

    PubMed  Google Scholar 

  80. Neldner KH, Hambidge KM (1975) Zinc therapy in acrodermatitis enteropathica. N Engl J Med 292:879–882

    PubMed  Google Scholar 

  81. Nishi Y, Lifshitz F, Bayne MA, Daum F, Silverberg M, Aiges H (1980) Zinc status and its relation to growth retardation in children with chronic inflammatory bowel disease. Am J Clin Nutr 33:2613–2621

    PubMed  Google Scholar 

  82. Ohlsson A (1981) Acrodermatitis enteropathica. Reversibility of cerebral atrophy with zine therapy. Acta Paediatr Scand 70:269–273

    PubMed  Google Scholar 

  83. Okade T, Miyao M (1981) Susceptibility to infection in zinc deficiency. Acta Paediatr Jpn 23:219

    Google Scholar 

  84. Oleske JM, Westphal ML, Shore S, Gorden D, Bogden JD, Nahmias A (1979) Zinc therapy of depressed cellular immunity in acrodermatitis enteropathica. Am J Dis Child 133:915–918

    PubMed  Google Scholar 

  85. Ølholm-Larsen P (1978) Untreated acrodermatitis enteropathica in adults. Dermatologica 156:155–166

    PubMed  Google Scholar 

  86. Ølholm-Larsen P (1979) Serum zinc levels in heterozygous carriers of the gene for acrodermatitis enteropathica. Identification of a carrier state is not possible. Hum Genet 46:65–74

    PubMed  Google Scholar 

  87. Owino FP (1979) Acrodermatitis enteropathica in a kenyan african child. East Afr Med J 56:690–692

    PubMed  Google Scholar 

  88. Parra CA, Smálik AV (1981) Percutaneous absorption of zinc in acrodermatitis enteropathica. Dermatologica 163:413–416

    PubMed  Google Scholar 

  89. Pass RF, Johnston RB, Cooper MD (1974) Agammaglobulinemia with B-lymphocytes in neonate with acrodermatitis enteropathica. Am J Dis Child 128:251–253

    PubMed  Google Scholar 

  90. Pelikán L, Kadousek R, Dućek S, Jarośová A (1979) Acrodermatitis enteropathica-porucha resorpcc zinku. Cesk Pediatr 34: 44–46

    PubMed  Google Scholar 

  91. Polanco I, Nistal M, Guerrero J, Vázquez C (1976) Acrodermatitis enteropathica, zinc, and ultrastructural lesions in paneth cell. Lancet I:430

    Google Scholar 

  92. Portnoy B and Molokhia M (1975) Zinc and diodoquin in acrodermatitis enteropathica. Lancet II:914–915

    Google Scholar 

  93. Prasad AS (1985) Laboratory diagnosis of zinc deficiency. J Am Coll Nutr 4:591–598

    PubMed  Google Scholar 

  94. Racz P, Kovacs B, Varga L, Ujlaki E, Zombai E, Karbuczky S (1979) Bilateral cataract in acrodermatitis. J Pediatr Ophthalmol Strabismus 16:180–182

    PubMed  Google Scholar 

  95. Rhim KY, Choi DY, Son SJ, Shin S (1980) Acrodermatitis enteropathica in two siblings. Korean J Dermatol 18:287–293

    Google Scholar 

  96. Rodin AE, Goldman AS (1969) Autopsy findings in acrodermatitis enteropathica. Am J Clin Pathol 51:315–322

    PubMed  Google Scholar 

  97. Rodriguez A, Soto G, Torres S, Venegas G, Castillo-Duran C (1985) Zinc and copper in hair and plasma of children with chronic diarrhea. Acta Paediatr Scand 74:770–774

    PubMed  Google Scholar 

  98. Rogers M (1980) Acrodermatitis enteropathica. Aust J Dermatol 21:71–75

    Google Scholar 

  99. Rosenblum JL, Schweitzer J, Kissane JM, Cooper TW (1985) Failure to thrive presenting with an unusual skin rash. J Pediatr 107:149–153

    PubMed  Google Scholar 

  100. Rothbaum RJ, Maur PR (1981) Serum alkaline phosphatase — a sensitive index of zinc undernutrition. J Pediatr 98:1023

    Google Scholar 

  101. Rubin IL, Hansen JDL, Goldberg B, Presbury DCG, Kilroe-Smith TA (1978) Acrodermatitis enteropathica — a zinc deficiency state. S Afr Med J 53:497–498

    PubMed  Google Scholar 

  102. Schmidt H, Riemann JF, Grosse K-P (1982) Klinik, Diagnostik und Therapie der Acrodermatitis Enteropathica. Leber Magen Darm 12:239–244

    PubMed  Google Scholar 

  103. Schulze RR, Winkelmann RK (1966) Acrodermatitis enteropathica: report of a patient responding to combined therapy with human milk and diiodohydroxyquin. Mayo Clin Proc 41:334–341

    PubMed  Google Scholar 

  104. Shelley WB (1982) Malignant melanoma and dermatofibrosarcoma in a 60-year-old patient with lifelong acrodermatitis. J Am Acad Dermatol 6:63–66

    PubMed  Google Scholar 

  105. Smith JC, Holbrook JT, Danford DE (1985) Analysis and evaluation of zinc and copper in human plasma and serum. J Am Col Nutr 4:627–638

    Google Scholar 

  106. Steiner GA (1978) Successful treatment of acrodermatitis enteropathica with zinc sulfate. Am J Hosp Pharm 35:1535–1538

    PubMed  Google Scholar 

  107. Strain WH, Hirsh FS, Michel B (1975) Increased copper/zinc ratios in acrodermatitis enteropathica. Lancet I:1196–1197

    Google Scholar 

  108. Strain WH, Hirsh FS, Michel B, Apgar J (1984) Copper: zinc interrelations in acrodermatitis enteropathica in humans and facial eczema in sheep. Trace Elem Med 1:35–42

    Google Scholar 

  109. Thyresson N (1975) Zinktherapie bei Acrodermatitis Enteropathica. Hautarzt 26:408–410

    PubMed  Google Scholar 

  110. Török E, Földes Gy, Frank K, Kereszty M, Kiss P, Molnár A, Révész T, Rosner Eg, Szigeti R, Török I (1978) Zur Frage der Acrodermatitis Enteropathica. Monatschr Kinderheilkd 126: 174–178

    Google Scholar 

  111. Van den Hamer CJA, Cornelisse C, Hoogenraad TU, Van Wouwe JP (1985) Use of69mZn loading test for monitoring of zinc malabsorption. In: Mills CF, Bremner I, Chesters JK (eds) Trace elements in man and animals — TEMA 5. Commonwealth Agricultural Bureaux, Slough UK, pp 689–691

    Google Scholar 

  112. Van Gool JD, Went K, Zegers BJM (1976) Acrodermatitis enteropathica and cellular immune deficiency. Lancet I:1085

    Google Scholar 

  113. Van Wouwe JP, Van den Hamer CJA (1985) Hair zinc in infancy and childhood. Sci Total Environ 42:149–155

    PubMed  Google Scholar 

  114. Van Wouwe JP, Wolff FA de, Van Gelderen HH (1986) Zinc in hair and urine of paediatric patients. Clin Chim Acta 155:77–82

    PubMed  Google Scholar 

  115. Van Wouwe JP, Van Gelderen HH, Bos JH (1987) Subacute zinc deficiency in children with recurrent upper respiratory tract infection. Eur J Pediatr 146:293–295

    PubMed  Google Scholar 

  116. Van Wouwe JP, Van Gelderen HH, Enschedé FAJ, Van de Velde EA (1988) Acute diarrhea, non-responsive to dietary restriction, zinc deficiency and subclinical growth retardation in pre-school children. Trace Elem Med 5:90–92

    Google Scholar 

  117. Vedder JS, Griem S (1956) Acrodermatitis Enteropathica (Danbolt-Closs) in 5 siblings, efficacy of Diodoquin in management. J Pediatr 48:212–219

    PubMed  Google Scholar 

  118. Verburg DJ, Burd LI, Hoxtell EO, Merrill LK (1974) Acrodermatitis enteropathica and pregnancy. Obstet Gynecol 44:233–237

    PubMed  Google Scholar 

  119. Walker BE, Bone I, Mascie-Taylor BH, Kelleher J (1979) Is plasma zinc a useful investigation? Int J Vitam Nutr Res 49:413–418

    PubMed  Google Scholar 

  120. Walldius G, Michaëlsson G, Hardell LI, Åberg H (1983) The effects of diet and zinc treatment on the fatty acid composition of serum lipids and adipose tissue and on serum lipoproteins in two adolescent patients with acrodermatitis enteropathica. Am J Clin Nutr 38:512–522

    PubMed  Google Scholar 

  121. Walravens PA, Hambidge KM, Weston M, Neldner KH (1976) Plasma zinc in acrodermatitis enteropathica. Lancet I:488

    Google Scholar 

  122. Walravens PA, Hambidge KM, Neldner KH, Silverman A, Doorninck WJ van, Mierau G, Favara B (1978) Zinc metabolism in acrodermatitis enteropathica. J Pediatr 93:71–73

    PubMed  Google Scholar 

  123. Weismann K, Hoe S, Knudson L, Sørensen SS (1979)65Zinc absorption in patients suffering from acrodermatitis enteropathica and in normal adults assessed by whole-body counting technique. Br J Dermatol 101:573–579

    PubMed  Google Scholar 

  124. Wells BT, Winkelmann RK (1961) Acrodermatitis enteropathica. Arch Dermatol 84:90–102

    PubMed  Google Scholar 

  125. Weston WL, Huff JC, Humbert JR, Hambidge KM, Neldner KH, Walravens PA (1977) Zinc correction of defective chemotaxis in acrodermatitis enteropathica. Arch Dermatol 113:422–425

    PubMed  Google Scholar 

  126. Wilson MC, Fisher TJ, Riordan MM (1982) Isolated IgG hypogammaglobulinaemia in acrodermatitis: correction with zinc therapy. Ann Allergy 48:288–291

    PubMed  Google Scholar 

  127. Zimmerman AW, Hambidge KM, Lepow ML, Greenberg RD, Stover ML, Casey CE (1982) Acrodermatitis enteropathica in breast-fed premature infants: evidence for a defect of mammary zinc secretion. Pediatrics 69:176–183

    PubMed  Google Scholar 

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  1. Department of Paediatrics, State University at Leiden, P.O. Box 9600, 2300 RC, Leiden, The Netherlands

    J. P. Van Wouwe

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Dedicated to the memory of H.H. Van Gelderen

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Van Wouwe, J.P. Clinical and laboratory diagnosis of acrodermatitis enteropathica. Eur J Pediatr 149, 2–8 (1989). https://doi.org/10.1007/BF02024322

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