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Zinc-induced copper deficiency in an infant
A S Botash1, J Nasca, R Dubowy
1Department of Pediatrics, State University of New York Health Science Center, NY 13210.
Objective:
To describe the case of a 13-month-old girl who developed copper deficiency as a result of excessive zinc gluconate ingestion.
Setting:
Tertiary care hospital in Syracuse, NY.
Interventions:
Cessation of zinc ingestion followed by intravenous and oral copper chloride therapy.
Measurements/Main Results:
Ingestion of zinc gluconate, 120 mg/d for 6 months, and thereafter 180 mg/d for 1 month, preceded the clinical presentation of listlessness, anemia, neutropenia, poor weight gain, abnormal sparse hair, and scorbuticlike bone changes. Findings on a bone marrow examination included ring sideroblasts and suggested copper deficiency. Plasma zinc level was 36.7 mumol/L, serum ceruloplasmin level was 20 mg/L, and serum copper level was undetectable. Clinical and laboratory abnormalities resolved shortly after initiation of copper therapy.
Conclusions:
This case demonstrates the reciprocal relationship of copper and zinc metabolism and exemplifies the important interrelationships of dietary trace minerals.