{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T14:18:27Z","timestamp":1785075507995,"version":"3.55.0"},"reference-count":14,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1989,10]]},"abstract":"<jats:p>We report a patient with acrodermatitis enteropathica and a normal serum zinc level in whom the diagnosis was confirmed by plasma phospholipid fatty acid and a small bowel biopsy response to oral zinc therapy. Acrodermatitis enteropathica is a rare autosomal recessive condition of zinc deficiency characterised by chronic diarrhoea associated with failure to thrive, periorificial dermatitis and alopecia, susceptibility to infections and behavioural changes. Diagnosis is usually established by reduced serum zinc levels (classical acrodermatitis enteropathica). Paneth cell abnormalities on electron microscope of a small bowel biopsy can be supportive. A few cases with the typical picture of acrodermatitis enteropathica without hypozincaemia (variant acrodermatitis enteropathica) have been described. The diagnosis of variant acrodermatitis enteropathica to date has been based on an entirely empiric, but nonetheless convincing clinical response to oral zinc therapy. Laboratory aids to diagnosis have been lacking.<\/jats:p>","DOI":"10.1136\/gut.30.10.1426","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1426-1429","source":"Crossref","is-referenced-by-count":34,"title":["Acrodermatitis enteropathica with normal serum zinc levels: diagnostic value of small bowel biopsy and essential fatty acid determination."],"prefix":"10.1136","volume":"30","author":[{"given":"D","family":"Mack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Koletzko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Cunnane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Cutz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1989,10,1]]},"reference":[{"issue":"1","key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/BF01811322","article-title":"Acrodermatitis enteropathica","volume":"6","author":"Aggett, P.J.","year":"1983","unstructured":"Aggett PJ. Acrodermatitis enteropathica. J 11jlerkit Metab Dis 1983; 6 (suppl 1): 39-43.","journal-title":"J 11jlerkit Metab Dis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0016-5085(19)32147-X","article-title":"Acrodermatitis enteropathica, zinc, and the paneth cell","volume":"73","author":"Bohane, T.D.; Cutz, E.; Hamilton, JR, Gall; D.G.","year":"1977","unstructured":"Bohane TD, Cutz E, Hamilton JR, Gall DG. Acrodermatitis enteropathica, zinc, and the paneth cell. Gastroenterology 1977; 73: 587-92.","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/S0022-3476(77)81333-4","article-title":"Acrodermatitis enteropathica without hypozincemia","volume":"91","author":"Garretts, M.; Molokhia, M.","year":"1977","unstructured":"Garretts M, Molokhia M. Acrodermatitis enteropathica without hypozincemia. J Pediatir 1977; 91: 492-4.","journal-title":"J Pediatir"},{"key":"ref_4","first-page":"773","article-title":"Zinc dependency as a cause of chronic diarrhea in variant acrodermatitis cnteropathica","volume":"69","author":"Kriegler 1, Evans GW, Zelkowitz PS","year":"1982","unstructured":"Kriegler 1, Evans GW, Zelkowitz PS. Zinc dependency as a cause of chronic diarrhea in variant acrodermatitis cnteropathica. Pediatrics 1982; 69: 773-7.","journal-title":"Pediatrics"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1093\/ajcp\/57.4.506","article-title":"Detcrmination of serum zinc concentration in normal adult subjects by atomic absorption spectrophotometry","volume":"57","author":"Pekarek, R.S.; Beisel, W.R.; Bartelloni, P.J.","year":"1972","unstructured":"Pekarek RS, Beisel WR, Bartelloni PJ, et al. Detcrmination of serum zinc concentration in normal adult subjects by atomic absorption spectrophotometry. 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Arcli Dis Child 1979; 54: 909-17.","journal-title":"Arcli Dis Child"},{"key":"ref_8","first-page":"21922","article-title":"Reversible intestinal mucosal abnormality in acrodermatitis enteropathica","volume":"51","author":"Kelly, R.; Davidson, G.P.; Townlcy, R.R.W.; Campbell, P.E.","year":"1976","unstructured":"Kelly R, Davidson GP, Townlcy RRW, Campbell PE. Reversible intestinal mucosal abnormality in acrodermatitis enteropathica. Arch Dis Child 1976; 51: 21922.","journal-title":"Arch Dis Child"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1203\/00006450-198305000-00009","article-title":"The effect of zinc therapy on lysosomal inclusion bodics in intestinal epithelial cells in acrodermatitis enteropathica","volume":"17","author":"Gwyn-Joncs, J.; Elmes, M.E.; Aggett, P.J.; Harries, J.T.","year":"1983","unstructured":"Gwyn-Joncs J, Elmes ME, Aggett PJ, Harries JT. The effect of zinc therapy on lysosomal inclusion bodics in intestinal epithelial cells in acrodermatitis enteropathica. Pediatir Res 1983; 17: 354-7.","journal-title":"Pediatir Res"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1203\/00006450-197402000-00003","article-title":"Ultrastructural findings in acrodermatitis cnteropathica","volume":"8","author":"Lombeck 1, von Bassewitz DB, Becker K","year":"1974","unstructured":"Lombeck 1, von Bassewitz DB, Becker K, et al. Ultrastructural findings in acrodermatitis cnteropathica. Pediair Res 1974; 8: 82-8.","journal-title":"Pediair Res"},{"key":"ref_11","first-page":"336","article-title":"Elektronenmikroskopische untersuchungen an paneth-zellen der ratte unter zinkarmer. Diat Beitr Pathol","volume":"145","author":"Oho, H.F.; Weitz, H.","year":"1972","unstructured":"Oho HF, Weitz H. Elektronenmikroskopische untersuchungen an paneth-zellen der ratte unter zinkarmer. 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