Zinc-dependent chemotactic defect in an infant with acrodermatitis

Area of Science:

• Pediatric Medicine
• Immunology
• Nutritional Science

Background:

• Acrodermatitis enteropathica (AE) is a rare genetic disorder of zinc absorption.
• Acquired zinc deficiency can occur due to inadequate dietary intake or absorption issues.
• Infant nutrition transitions, such as weaning, can impact nutrient status.

Observation:

• A 5-month-old infant presented with clinical signs of acrodermatitis enteropathica upon weaning from breast milk to cow's milk.
• The infant exhibited low plasma zinc concentrations.
• Immune function assessment revealed normal T- and B-lymphocyte activity but severely impaired neutrophil chemotaxis.

Findings:

• Oral zinc sulfate administration (40 mg daily) led to rapid clinical improvement of the skin lesions.
• Plasma zinc levels were restored to normal following zinc supplementation.
• Neutrophil chemotaxis function normalized completely after zinc treatment, indicating reversal of the immune defect.

Implications:

• This case underscores the importance of adequate zinc levels for proper immune function, particularly neutrophil chemotaxis, in infants.
• Zinc deficiency, even when acquired, can manifest with significant dermatological and immunological consequences.
• Dietary zinc monitoring and supplementation should be considered during infant weaning and in cases of suspected zinc deficiency.