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Al Qurashi M, Mohammad H, Aga SS, Mustafa A, Alallah J, Al Hindi M, Al Harbi M, Hasosah M. Acquired Zinc Deficiency in Preterm Infant Post-Surgery for Necrotizing Enterocolitis (NEC) on Prolonged Total Parenteral Nutrition (TPN). Pediatr Rep 2024; 16:551-557. [PMID: 39051233 PMCID: PMC11270164 DOI: 10.3390/pediatric16030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/20/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Zinc (Zn) is a vital trace element that plays a pivotal role in protein synthesis, cellular growth, and differentiation and is involved as a cofactor of metalloenzymes, performing a wide variety of metabolic, immune, and synthesis roles. Zn is required at all stages of an infant's and child's development, and severe Zn deficiency has been reported to lead to slower physical, cognitive, and sexual growth. Preterm neonates are at a higher risk of developing zinc deficiency for a variety of reasons, including low Zn intake from enteral feeds containing breast milk, relative malabsorption due to immaturity of the gastrointestinal tract with limited absorptive capacity, increased urinary loss of zinc, and increased demand during the early developmental stages. Moreover, premature infants are at risk of gastrointestinal diseases like necrotizing enterocolitis (NEC), which can limit absorption capacity and potentially lead to malabsorption. TPN is frequently used in preterm infants to provide them with sufficient nutrients and calories. However, it has its own complications, including cholestasis, especially if used for prolonged periods. In this case report, we are presenting the case of a male preterm infant who was delivered by caesarean section at 26 weeks' gestation. The baby developed an intestinal perforation due to NEC, for which he underwent surgery for resection of the necrotic bowel and the creation of a high ileal stoma and was put on prolonged total parenteral nutrition (TPN), which led to the development of zinc deficiency.
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Affiliation(s)
- Mansour Al Qurashi
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
| | - Hadeel Mohammad
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
| | - Syed Sameer Aga
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
- Basic Medical Sciences, College of Medicine, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia
| | - Ahmed Mustafa
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
| | - Jubara Alallah
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
| | - Mohammed Al Hindi
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
| | - Mohammed Al Harbi
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
| | - Mohammed Hasosah
- Department of Pediatrics, Ministry of National Guard Health Affairs (MNGHA), King Saud bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Jeddah 21423, Saudi Arabia; (M.A.Q.); (H.M.); (A.M.); (J.A.); (M.A.H.); (M.A.H.); (M.H.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah 21423, Saudi Arabia
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Zinc Deficiency-Associated Dysgeusia Preventing the Improvement of Severe Hyperemesis Gravidarum. Case Rep Obstet Gynecol 2022; 2022:7486501. [PMID: 36618851 PMCID: PMC9812587 DOI: 10.1155/2022/7486501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/29/2022] Open
Abstract
A 23-year-old primigravida visited the hospital frequently since the early phase of her pregnancy because of severe hyperemesis gravidarum. She was hospitalized for the same at 14 weeks and 1 day of pregnancy. After admission, peripheral intravenous nutrition was started; however, her symptoms did not improve. At 17 weeks and 1 day of gestation, a blood sample was collected to determine the presence of trace element deficiencies, and a zinc deficiency was revealed. We examined the patient's symptoms and found that she had developed dysgeusia. After receiving a zinc preparation, her taste disorder gradually improved, and her oral intake increased. Her hyperemesis gravidarum resolved, and she was discharged from the hospital at 18 weeks and 2 days of gestation. The findings from this case suggest that prolonged peripheral intravenous nutrition in patients with severe hyperemesis gravidarum can lead to zinc deficiency and impede the successful treatment of hyperemesis gravidarum.
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Jain RB, Ducatman A. Associations of serum perfluoroalkyl substances with concentrations of blood manganese and selenium. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:90098-90107. [PMID: 35864399 DOI: 10.1007/s11356-022-22089-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/14/2022] [Indexed: 01/06/2023]
Abstract
The aim of this study was to estimate the associations of blood manganese and selenium with serum concentrations of selected perfluoroalkyl substances (PFAS). The presence or absence of this association is important because PFAS have documented pro-oxidant properties, whereas manganese and selenium are critical to antioxidant responses. For this purpose, the data from NHANES for US adults aged ≥ 20 years (N = 3982), adolescents aged 12-19 years (N = 1524), and children aged 3-11 years (N = 639) were analyzed. Among adults, concentrations of blood manganese were found to be inversely associated with serum concentrations of perfluorooctanoic acid or PFOA (β = - 0.04204, p < 0.01), perfluorononanoic acid or PFNA (β = - 0.02700, p < 0.01), perfluorohexane sulfonate or PFHxS (β = - 0.04306, p < 0.01), and perfluorooctane sulfonate or PFOS (β = - 0.04494, p < 0.01). Blood concentrations of selenium were found to be positively associated with PFHxS only among adults (β = 0.000678, p = 0.047) and adolescents (β = 0.01377, p = 0.02). The Mn results but not the less consistent Se associations were robust to adjustments for serum albumin. Possible reasons for the inverse association of PFOA, PFHxS, PFNA, and PFOS with Mn among US adults are discussed. The finding raises concerns about manganese's diminished ability to mount antioxidant responses to PFAS exposure.
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Affiliation(s)
| | - Alan Ducatman
- West Virginia University School of Public Health, Morgantown, WV, USA
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