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Trace metal and essential fatty acid deficiency during total parenteral nutrition

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Abstract

While deficiencies of trace metals and essential fatty acids are rare in humans fed orally, the widespread use of total parenteral nutrition (TPN) has increased the likelihood of encountering these deficiencies. A 14-year-old boy, with total villous atrophy of the small intestine, suffered from severe malnutrition and was placed on a conventional TPN regimen. Although not immediately recognized, he rapidly developed deficiencies of zinc, copper and essential fatty acids. Careful monitoring of the course of the illness and the responses to sequential treatments with zinc, lipid, and copper given intravenously allowed examination of the effects of the deficiencies on skin, intestine, liver, and hemopoietic systems and helped to establish normal requirements for the metals. The progress of the illness suggested that patients with intestinal malabsorption may be especially at risk of developing some of these lesser known complications of TPN.

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Authors and Affiliations

  1. National Institute of Arthritis, Metabolism and Digestive Diseases, and The National Cancer Institute, National Institutes of Health, Bldg. 10 Room 9D-15, 20014, Bethesda, Maryland

    Denis M. McCarthy MD, Roger J. May MD, Michelle Maher RN & Murray F. Brennan MD

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  1. Denis M. McCarthy MD
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  2. Roger J. May MD
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  3. Michelle Maher RN
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  4. Murray F. Brennan MD
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McCarthy, D.M., May, R.J., Maher, M. et al. Trace metal and essential fatty acid deficiency during total parenteral nutrition. Digest Dis Sci 23, 1009–1016 (1978). https://doi.org/10.1007/BF01263101

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