Acrodermatitis enteropathica Reversibility of cerebral atrophy with zinc therapy

A six-month-old Saudi boy with acrodermatitis enteropathica confirmed by low serum zinc and alkaline phosphatase levels is described. Both the patient and a sibling developed acrodermatitis enteropathica while entirely breastfed. The mother had low serum zinc levels. Cranial computed tomography initially showed marked central and cortical "atrophy" that improved on treatment with zinc sulphate. The importance of zinc for normal brain growth and function is well known and the improvement on cranial computed tomography could be explained by improved myelination.