Summary
Definition
History and exam
Key diagnostic factors
- increased susceptibility to infection
- taste disorders
- stomatitis
- delayed wound healing
- acrodermatitis enteropathica
- fertility issues/adverse pregnancy outcomes
Other diagnostic factors
- fatigue
- gastrointestinal symptoms
- short stature
- bone fracture
- impaired glucose tolerance
- dermatitis
- weight loss
- alopecia
- paronychia
- fever
- intention tremor
- depression
- impaired concentration
- nystagmus
- dysarthria
- night blindness
- hypogeusia
- anosmia
- blepharitis
- dementia
Risk factors
- living in a developing region
- age >65 years
- chronic gastrointestinal (GI) and liver disease
- renal disease
- sickle cell disease
- diabetes mellitus
- chronic treatment with hydrochlorothiazide, penicillamine, ethambutol, certain antibiotics
- HIV infection
- alcoholism
- long-term vegetarian/vegan diets
- specialized weight-loss diets
- infants with nutrient-poor diets
- family history of zinc deficiency
- anorexia nervosa
Diagnostic tests
1st tests to order
- serum or plasma zinc levels
- serum iron level
- serum 25-OH vitamin D level
- serum folate
- serum vitamin B12
Emerging tests
- cell zinc content
- analysis of zinc levels in hair
- genetic testing for acrodermatitis enteropathica
Treatment algorithm
acquired
acrodermatitis enteropathica
Contributors
Authors
Prashant Singh, MD
Assistant Professor of Medicine
Division of Gastroenterology and Hepatology
University of Michigan
Ann Arbor
MI
USA
Disclosures
PS declares that he has no competing interests.
Judy Nee, MD
Instructor in Medicine
Division of Gastroenterology
Beth Israel Deaconess Medical Center
Boston
MA
Disclosures
JN declares that she has no competing interests.
Acknowledgements
Dr Prashant Singh and Dr Judy Nee would like to gratefully acknowledge Dr Daniel Leffler, a previous contributor to this topic.
Disclosures
DL declares that he has no competing interests.
Peer reviewers
Hajo Haase, PhD
Assistant Professor for low molecular weight immune regulators
Institute of Immunology
University Hospital
RWTH Aachen University
Aachen
Germany
Disclosures
HH has been reimbursed by Kohler Pharma, the manufacturer of UNIZINK, for attending a symposium and has received a fee for speaking at that symposium. HH is an author of a number of references cited in this topic.
Andrew Fenves, MD
Professor of Medicine
Baylor University Medical Center
Dallas
TX
Disclosures
AF declares that he has no competing interests.
Differentials
- Hypothyroidism
- Depression
- Iron deficiency
More DifferentialsGuidelines
- Japan's practical guidelines for zinc deficiency with a particular focus on taste disorders, inflammatory bowel disease, and liver cirrhosis
- 2020-2025 Dietary Guidelines for Americans
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