Two cases of long-term zinc acetate hydrate administration in patients with a zinc deficiency taste disorder with copper deficiency after upper gastrointestinal resection.

BACKGROUND & AIMS: Long-term oral administration of zinc preparations to zinc-deficient patients has been shown to result in copper deficiency. Two patients who had zinc deficiency taste disorder and copper deficiency after upper gastrointestinal resection were treated with zinc acetate hydrate.

METHODS

Two patients with abnormal taste were diagnosed as zinc deficiency taste disorder by an examination, and were treated with zinc replacement therapy. Case 1 (BMI 15.6 kg/mm2) was given 50 mg/day of zinc acetate hydrate for a year. On the other hand, case 2 (BMI 24.2 kg/mm2) started treatment with zinc acetate hydrate at a concentration of 100 mg/day, but due to pancytopenia, the dose was reduced to 25 mg/day, and the drug was administered for a total of 5 years.

RESULTS

Both patients demonstrated an improvement in taste. In case 1, the serum zinc level reached 111 μg/dL after a year of zinc acetate hydrate treatment. There was no decrease in serum copper levels or blood cell counts. Case 2 had pancytopenia with neutrophils 320/mm3, Hb 7.1 g/dL, and platelets 164 × 109/L one year after zinc acetate hydrate administration. The patient was given subcutaneous G-CSF and a transfusion of concentrated red blood cells and was started on oral administration of pure cocoa 10 g/day. However, pancytopenia did not improve; thus, discontinuing and reducing zinc acetate hydrate increased serum copper and improvement of pancytopenia. Due to the history of spinal canal stenosis surgery, it was difficult to evaluate the neurologic abnormalities.

CONCLUSION

Long-term administration of zinc supplements should be administered with caution to patients with zinc deficiency-related taste disorders following upper gastrointestinal resection, particularly those with poor nutritional status.