Oral adverse events due to zinc deficiency after pancreaticoduodenectomy requiring continuous intravenous zinc supplementation: a case report and literature review

Abstract

Background Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies on the development of zinc deficiency after PD and reported about a patient with zinc deficiency after PD who required home intravenous zinc replacement. Case presentation A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously during readmission. Her serum zinc levels recovered, and her lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home. Conclusions Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of the oral adverse events, such as dysgeusia, glossitis, and oral pain, associated with zinc deficiency after cancer surgery and that induced by chemotherapy or head and neck radiation therapy.

Factors Affecting the Readmission of Patients with Pancreatic Cancer after Surgery

“…Previous studies have shown that postoperative nutritional imbalance was associated with the postoperative death of approximately 10% of pancreatic cancer patients [7,8]. Further, inadequate nutritional intake was found to be asso-ciated with increased stress response, slow wound healing, and high postoperative infection rates, which could lead to higher risks for readmission [9,10]. Thus, we hypothesized that the readmission of pancreatic cancer patients after surgery could be associated with gastrointestinal factors, stress responses, and immune status.…”

Zinc Acetate Dihydrate Tablet-Associated Gastritis Occurring in a Post-Hematopoietic Stem Cell Transplant Recipient

“…Low-birth-weight infants, pregnant women, and the elderly are prone to zinc defciency. Chronic liver disease, short bowel syndrome, diabetes, chronic renal disease, long-term use of chelating agents, parenteral nutrition, and tube feeding with insufcient zinc supplementation may also cause zinc defciency [1][2][3][4][5][6]. Zinc defciency leads to taste disorders, dermatitis, hair loss, anemia, stomatitis, male sexual dysfunction, increased susceptibility to infections, and osteoporosis.…”