Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Diamanti, Antonella; Basso, Maria S.; Candusso, Manila; Panetta, Fabio; Gambarara, Manuela
Hepatology, Gastroenterology and Nutrition Unit, Children's Hospital “Bambino Gesù,” Rome, Italy
To the Editor:
We read with great interest the article by Halac et al (1) about the clinical management of microvillus inclusion disease (MID). They reported the main clinical complications observed over time in MID as growth failure, developmental delay, osteoporosis, and liver and kidney disease. We would like to emphasize the high prevalence in these patients of trace element deficiencies. We have studied 5 patients with MID in the last 20 years. Four patients developed trace element deficiencies, despite standard parenteral supplementation and additional zinc (2). Three of them presented with acrodermatitis enteropathica–like rash. Serum zinc level was in all of the cases under the normal range (66–110 μg/100 mL). Serum zinc level normalized after further zinc intravenous supplementation, and rash improved in all 3 patients. One patient developed macrocytic anemia and neutropenia that did not respond to combined iron and parenteral vitamin B12 supplementation. Bone marrow examination revealed findings considered suggestive of copper deficiency (3). Serum copper level was 10 μg/100 mL (normal range 75–145 μg/100 mL). After supplementation, copper level normalized and anemia and neutropenia resolved.
In our experience, patients with MID seem to be at high risk of developing zinc and copper deficiency, likely because of the loss of gastrointestinal fluids high in zinc and copper content. We recommend close monitoring of serum zinc and copper (twice yearly).
Copyright 2012 by ESPGHAN and NASPGHAN
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Journal of Pediatric Gastroenterology and Nutrition.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in for
days or until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Visit JPGN.org on your smartphone. Scan this code (QR reader app required) with your phone and be taken directly to the site.