Acrodermatite enteropática ou síndrome de má absorção secundária à fibrose cística?

Abstract

Cystic fibrosis (CF) is a multi-systemic disease, which can affect many organs, such as the gastrointestinal system, making individuals with CF have difficulty absorbing many nutrients, leading to malabsorption syndrome. Another disease whose repercussions derives from bowel malabsorption is the acrodermatitis enteropathica, which is a rare genetic autosomal recessive disorder of zinc deficiency. We present a case of a child born at term, low birthweight, without clinical complications at birth. He was referred to the CF center at 5 months of age, due to alteration with the newborn screening for CF and the sweat test, failure to thrive and clinic steatorrhea. Based on the diagnostic hypothesis of acrodermatitis enteropathica, we initiated oral supplementation with zinc gluconate 1mg/kg/day, empirically, for serum level was unavailable. Therapeutic measures for CF were introduced, such as: hyper caloric diet, vitamin supplements, pancreatic enzymes, increase in salt and water input. Rapid and meaningful improvement of the skin lesions. The case shows the importance to consider acrodermatitis enteropathica and CF as differential diagnosis.