Nutrition classics. The American Journal of Medicine, Volume 31, 1961. Syndrome of iron deficiency anemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia.
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Biomedical subjects
Publications and source records attributed to J A Halsted.
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The effects of supplementation of the diets of 6- to 12-year-old children in a village near Shiraz in Iran with zinc plus iron or iron alone, together with the indispensable amino acids in the form of egg white protein, vitamins, minerals, and corn oil have been evaluated. Initially 48 of 59 children had zinc concentrations below the minimum found in well-nourished persons. Eight months of supplementation with zinc plus iron (20 mg daily of elemental zinc as carbonate and 20 mg ferrous iron as fumarate) failed to stimulate growth or bone development or to bring about an increase in plasma zinc concentrations. However, supplementation with iron in the above amount was associated with an acceleration of growth in height and weight. The persistence of low concentrations of zinc in plasma and the failure of supplemental zinc to stimulate growth are attributed to the poor availability of both dietary and supplemental zinc resulting from sequestering action of fiber and phytate present in large amounts in the unleavened whole meal bread consumed by villagers. In addition, the results suggest that simultaneous administration of iron and zinc supplements may impair utilization of the metals.
The syndrome of dwarfism, hypogonadism, iron-deficiency anemia and geophagia, first reported in 1960 from Iran, was thought to be limited to males. In 1971-1972 two females with the same clinical features were observed over a 14-month period. The anemia responded rapidly to iron. Growth and sexual development occurred promptly when 120 mg of zinc sulfate was administered daily in conjunction with a well-balanced diet and iron supplement. This diet prior to the addition of zinc sulfate, resulted in gradual but much slower growth and sexual development. Observations in these two patients provide confirmation of the occurrence of human zinc deficiency in females, which responds to large doses of zinc salt.
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Zinc is necessary to maintain normal concentrations of vitamin A in plasma. By using animals deficient in both zinc and vitamin A, it was demonstrated that zinc is necessary for normal mobilization of vitamin A from the liver. These results suggest that cases of depressed vitamin A in plasma, unresponsive to vitamin A therapy, may respond to zinc supplementation.
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