Acrodermatitis Enteropathica by Pooya Khan Mohammad Beigi & Emanual Maverakis

Author:Pooya Khan Mohammad Beigi & Emanual Maverakis
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

5.4 Clinical Diagnosis

Arriving at the diagnosis of AE relies on the ability of the clinician to recognize the constellation of distinct symptoms. However, the presenting signs other than skin lesions often vary with the age of the patient. Clinical findings such as psoriasis manifestations, symmetrical lesions, alopecia, anorexia, neurological disorders, diarrhea, and mood changes have been often reported in infants; while mental retardation, alopecia, weight loss, secondary infections, and growth problems have been reported in toddlers and school aged children.

Laboratory examinations are interpreted in support of the clinical symptoms, but cannot be a substitute in the absence of the appropriate clinical findings. Estimations of zinc levels in serum, urine, and hair are used to diagnose zinc deficiency in individuals. Nevertheless, interpretation of laboratory results is prone to some difficulty because of the potential overlap of the clinical symptoms of AE with coincident findings that may be observed in healthy individuals such as dermatitis. Additionally, low zinc levels in serum, urine, and hair are also observed in other disease and disorders. As a result, the age of the patient and albumin levels of serum are also considered for a more precise and accurate diagnosis. A more specific and accurate laboratory test is often necessary. In vitro or in vivo zinc absorption tests are performed using zinc radioisotopes zinc-65 or zinc-69.

In the absence of diagnostic hypozincemia the above laboratory tests, 3–30 μ mole of zinc per kilogram is prescribed for 5 days. This treatment is especially recommended for infants or children with one or more symptoms of AE. A positive response to this treatment would be a retrospective support of the clinical diagnosis [6, 20].

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