Zinc and biotin deficiencies after pancreaticoduodenectomy

We report zinc and biotin deficiencies after pancreatico- duodenectomy in a 16 year old female presenting clinically with marked alopecia, total body hair loss, dry skin with scales, and maculopathy with significant vision loss. These micronutrient defi- ciencies likely occurred due to resection of the duodenum and proximal jejunum, sites of primary absorption of several micro- nutrients and their protein carriers, including zinc and biotin. Early diagnosis is essential to prevent irreversible sequelae. Adequate supplementation of zinc and biotin as well as dietary advice is needed for clinical improvement. (Acta gastroenterol. belg., 2010, 73, 283-286).