ABSTRACT
BACKGROUND AND AIMS: Zinc (Zn) quantification is of particular interest in many clinical condition (e.g. inflammatory disease, critical care). Currently, Zn status is assessed by measuring plasma/serum concentration. This concentration corresponds to the sum of unbound Zn (Zn-Cu) and Zn highly bound to albumin (Zn-Cb). METHODS: Using a pharmacokinetic approach to the interpretation of total Zn concentration (Zn-Ct), taking into account Zn-Cu and the influence of hypoalbuminemia on Zn-Cb, it is possible to improve the individualization of Zn repletion. RESULTS: Therefore, during pregnancy and in certain inflammatory disease situations, repletion may not be necessary. However, as in critical care, it would be more appropriate to perform Zn-Cu assays to improve Zn repletion. CONCLUSION: Coupled total and unbound Zn should be monitored in order to individualize Zn repletion.
Subject(s)
Copper , Zinc , Pregnancy , Female , Humans , Zinc/metabolismSubject(s)
Choroidal Neovascularization/etiology , Feeding Behavior , Macular Degeneration/etiology , Oxidative Stress/physiology , Vitamins/blood , Aged , Aged, 80 and over , Antioxidants/metabolism , Case-Control Studies , Choroidal Neovascularization/blood , Choroidal Neovascularization/epidemiology , Female , France , Humans , Life Style , Macular Degeneration/blood , Macular Degeneration/epidemiology , Male , Middle Aged , Pilot Projects , Risk Factors , Smoking/epidemiology , Zinc/blood , beta Carotene/bloodABSTRACT
Thiamine deficiency is recognized in varied parts of the world. In Asia, it remains an important public health problem where highly polished rice is the major staple food and where other primary dietary sources of thiamine are in short supply. Beriberi, or clinically apparent thiamine deficiency, may present a variety of syndromes including myocardial dysfunction or wet beriberi, dry beriberi with neurological symptoms, and the more severe form Shoshin beriberi with cardiac failure and lactic acidosis. Infantile thiamine deficiency is a very rare condition in developed countries today. It occurs mainly in breastfed infants of mothers who have inadequate intake of thiamine. Clinical symptoms in such infants include gastrointestinal symptoms, cardiac failure, and lactic acidosis. We report the case of a 10-week-old girl, admitted with diarrhea, vomiting, acidosis, and cardiac failure. After excluding other etiologies of cardiomyopathy, biochemical thiamine deficiency confirmed the diagnosis of beriberi in an infant of a thiamine-deficient mother from Reunion Island, a French island where recently, with Mayotte Island, epidemic cases of beriberi have been described. This case is important to highlight the manifestations in young infants and to alert physicians to the possibility of thiamine deficiency in developed countries.
