Tissue zinc levels in a child with hypercalprotectinaemia and hyperzincaemia: A case report and a review of the literature

Abstract

Background. A girl suffering from a rare syndrome of unknown aetiology, termed hypercalprotectinaemia, was evaluated for tissue zinc status, because calprotectin is a protein which chelates Zn at multiple binding-sites, which might have affected the distribution of Zn in her body. Methods. Measurement of serum, urine, hair and nail zinc (Zn) concentration, complemented with measurement of total Zn in ultrafiltrates of plasma. Results. Her serum Zn concentration was 105–133 μmol/L. Zn levels in her hair (102 μg/g), nail (90 μg/g) and urine (3–12 μmol/L; 20–80 μg/dL) were all at the lower end of the reference intervals described in the sparse literature. Zn concentrations in ultrafiltrates of plasma were below the detection limit (<100 nmol/L). Thus, the elevated serum Zn did not translate into a similarly increased level of Zn in any of the tissues tested, nor in free Zn concentrations. Instead it appeared to be a result of Zn being chelated to binder proteins, most probably calprotectin. Conclusion. Her grossly elevated serum calprotectin concentration is probably able to raise circulating total Zn concentrations without raising ionized concentrations, but this Zn remains confined to the circulating blood as well as to excreted body fluids, particularly faeces.

Key Words::

• Tissue zinc
• zinc excretion
• calprotectin
• inflammation
• growth retardation

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.