Abnormal Immune Responses during Hypozincaemia in Acrodermatitis Enteropathica

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Abstract
Immune responses were characterized in six patients with acrodermatitis enteropathica during a break in zinc supplementation and during resupplementation. During hypozincaemia the number of T-cells increased but the amount of B-cells and the responses of T- and B-lymphocytes to phytohaemagglutinin, concanavalin A-, pokeweed mitogen- and Staphylococcus aureus stimulations in vitro were subnormal. Cell counts and stimulation results both normalized when serum zinc values improved. One patient was anergic to tuberculin while showing signs of acrodermatitis enteropathica; she converted during supplementation whereas the others were continuously positive. Three females had antibodies against nuclear antigens and slightly elevated serum IgE concentrations; these values were not affected by the break in supplementation. Four females were continuously rheumatoid factor positive. Our findings suggest that (i) zinc deficiency is closely associated with impaired immune responses in patients with acrodermatitis enteropathica, and (ii) laboratory markers of autoimmunity occur in a considerable number of the acrodermatitis enteropathica patients, irrespective of their zinc status.