"Acrodermatitis enteropaihica" is seen in deficiency of

Ans. b (Zinc) (Ref. Robbins 7'h/461; Table 9.24; H-17th/ Table 71-2)Robbins 7th/p. 461Essential features of zinc deficiency are:# Distinctive rash, often around the eyes, nose, mouth, anus and distal parts.# Anorexia, often accompanied by diarrhoea# Growth retardation in children# Impaired wound healing# Hypogonadism with i reproductive capacity.# Altered immune function# Impaired night vision related to altered vitamin A metabolism# Depressed mental function# Increased incidence of congenital malformation in infants of Zn-deficient mothers.Micro and macroelementslementDeficiencyToxicityTolerable Upper (Dietary) Intake LevelBoronNo biologic function determinedDevelopmental defects, male sterility, testicular atrophy20 mg/d (extrapolated from animal data)CalciumReduced bone mass(osteoporosis)Renal insufficiency (milk-alkali syndrome), nephrolithiasis, impaired iron absorption2500 mg/d (milk-alkali)CopperAnemia, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deteriorationNausea, vomiting, diarrhea, hepatic failure, tremor, mental deterioration, hemolytic anemia, renal dysfunction10 mg/ d (liver toxicity)ChromiumImpaired glucose toleranceOccupational: renal failure, dermatitis, pulmonary cancerNDFluorideDental cariesDental and skeletal fluorosis, osteosclerosis10 mg/d (fluorosis)IodineThyroid enlargement, T4, cretinismThyroid dysfunction, acne-like eruptions1100 g/d (thyroid dysfunction)IronMuscle abnormalities, koilonychia, pica, anemia, work performance, impaired cognitive development, premature labor, perinatal maternal mortalityGastrointestinal effects (nausea, vomiting, diarrhea, constipation), iron overload with organ damage, acute systemic toxicity45 mg/d of elemental iron (GI side effects)ManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashGeneral: Neurotoxicity, Parkinson-like symptoms Occupational: Encephalitis- like syndrome, Parkinson-like syndrome psychosis, pneumoconiosis11 mg/d (neurotoxicity)MolybdenumSevere neurologic abnormalitiesReproductive and fetal abnormalities2 mg/d extrapolated from animal dataSeleniumCardiomyopathy, heart failure, striated muscle degenerationGeneral: Alopecia, nausea, vomiting, abnormal nails, emotional lability, peripheral neuropathy, lassitude, garlic odor to breath, dermatitis Occupational: Lung and nasal carcinomas, liver necrosis, pulmonary inflammation400 g/d (hair, nail changes)PhosphorousRickets (osteomalacia), proximal muscle weakness, rhabdomyolysis, paresthesia, ataxia, seizure, confusion, heart failure, hemolysis, acidosisHyperphosphatemia4000 mg/dZincGrowth retardation, taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonadal atrophy, congenital malformationsGeneral: Reduced copper absorption, gastritis, sweating, fever, nausea, vomitingOccupational: Respiratory distress, pulmonary fibrosis40 mg/d (impaired copper metabolism)