Zinc containing dental fixative causing copper deficiency myelopathy
Liam Stuart Carroll1, Azmil H Abdul-Rahim1, Rosanne Murray1
1Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK.
BMJ Case Reports
|August 10, 2017
Summary
A man developed severe neurological symptoms due to copper deficiency caused by excessive zinc intake from dental paste. Early diagnosis and treatment of this hyperzincaemia-induced hypocupraemia are crucial for preventing permanent nerve damage.
Area of Science:
- Neurology
- Toxicology
- Metabolic Disorders
Background:
- Chronic use of zinc-containing products can lead to adverse health effects.
- Copper deficiency can manifest with significant neurological deficits.
Observation:
- A 62-year-old male presented with progressive lower limb instability, paresthesia, pain, and weakness.
- Neurological examination revealed upper motor neuron signs and loss of proprioception.
- Serum analysis showed reduced ceruloplasmin and copper with elevated zinc levels.
Findings:
- Spinal imaging (including 3T MRI) identified dorsal column intensity changes from C2-C7.
- Diagnosis of copper deficiency myeloneuropathy was established, secondary to chronic zinc dental fixative paste use.
- Despite discontinuing the zinc paste and initiating copper supplementation, neurological recovery was incomplete.
Implications:
- This case highlights hyperzincaemia-induced hypocupraemia as a cause of myeloneuropathy.
- Prompt recognition and intervention are essential to prevent irreversible neurological damage.
- Awareness of potential toxicity from over-the-counter zinc products is critical for clinicians.
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