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Trace-element Deficiencies in Microvillous Inclusion Disease

Halac, Ugur; Lacaille, Florence; Joly, Francisca; Hugot, Jean-Pierre; Talbotec, Cécile; Colomb, Virginie; Ruemmele, Frank; Goulet, Olivier

Journal of Pediatric Gastroenterology and Nutrition: May 2012 - Volume 54 - Issue 5 - p 699
doi: 10.1097/MPG.0b013e31824f8790
Letters to the Editor

Pediatric Gastroenterology, Hepatology and Nutrition Unit, Necker-Enfants Malades, Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France

To the Editor: Diamanti et al (1) provide an interesting observation of 4 children with zinc and/or copper deficiencies associated with acrodermatitis enteropathica–like rash in 3 and macrocytic anemia and neutropenia in 1 patient with microvillus inclusion disease. Our report represents a large group of 24 European children who were referred to our center during a 14-year period with this rare and severe autosomal recessive disorder (2). A limitation of our retrospective study is that analyses of blood trace element and mineral levels were not available; however, all of our patients received standard parenteral supplementation of minerals and trace elements (3), and none had any reports of dermatologic features during follow-up. Despite the small number of patients in Diamanti et al's report, this information is clinically relevant. Providers caring for patients with microvillus inclusion disease need to heed this important message.

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1. Diamanti A, Basso MS, Candusso M, et al. Zinc and copper deficiency in the microvillus inclusion disease. J Pediatr Gastroenterol Nutr 2012;54:297.
2. Halac U, Lacaille F, Joly F, et al. Microvillous inclusion disease: how to improve the prognosis of a severe congenital enterocyte disorder? J Pediatr Gastroenterol Nutr 2011; 52:460–465.
3. Koletzko B, Goulet O, Hunt J, et al. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). J Pediatr Gastroenterol Nutr 2005; 41:S1–S87.
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