Zdorovʹe Rebenka (Apr 2019)
Comparative assessment of serum zinc and IgA levels in children with acute intestinal infections
Abstract
Background. New WHO guidelines for the treatment of diarrhea relate to the use of zinc (Zn). The use of Zn for diarrhea treatment improves the absorption of water in the intestine, accelerates the regeneration of enterocytes, increases the number of intestinal enzymes, improves the immune response, an important part of which is IgA. The purpose was to determine the serum level of Zn and IgA in young children in the dynamics of acute infectious diarrhea (ID) of bacterial and viral etiology. Materials and methods. Thirty-six children aged from 4 months to 15 years with infectious diarrhea were examined. The children were divided into three groups: I — 14 children under 2 years with bacterial ID, II — 9 children of the corresponding age with a viral one, III — 13 children over 2 years. In children, serum Zn and Ig A levels were determined on the 1st and 5th day of treatment. Results. It was established that a low level of serum Zn was observed on the 1st day of inpatient treatment in 19.44 % of patients with ID, and in 25 % — above the norm. The patients of groups I and II had a low level of Zn in 26.09 % cases, higher than the norm — in 13.04 % (6.78–35.5 μmol/l), and 11.11 % children of group III had low values and 66.67 % — high velel (7.9–9.5 µmol/l). There were no differences in the frequency of hypozincaemia in young children with ID of rotavirus and bacterial etiology. The reduced level of serum IgA was determined in every 8th patient among young children in the first days of inpatient treatment, in the absence of relative changes in the older age group. On day 5 of inpatient treatment, zinc and serum IgA values normalized in all children. Conclusions. Thus, a quarter of young children in the acute period of viral or bacterial ID presented with zinc and serum IgA deficiency. To clarify the role of zinc and serum IgA during the course of ID, it is recommended to conduct further clinical and laboratory examinations.
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