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Updated: Sep 14, 2025

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Anemia Due to Unexpected Zinc-Induced Copper Deficiency.

Nicholas Chun1, Shehla Aman1, Dan Xu1

  • 1Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.

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|July 23, 2025
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Summary

Excess zinc intake can cause copper deficiency anemia. Bone marrow examination revealing vacuolated precursors is key to diagnosing this condition, preventing misdiagnosis of myelodysplasia or vitamin B12 deficiency.

Keywords:
anemiacopperdietaryleukopenianeutropeniasideroblastzinc

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Area of Science:

  • Hematology
  • Toxicology
  • Nutritional Science

Background:

  • Anemia is commonly linked to malabsorption or dietary issues.
  • Excessive zinc intake can impair copper absorption, leading to acquired copper deficiency.
  • Copper deficiency anemia may present with bone marrow abnormalities.

Observation:

  • A case of an 18-year-old female with anemia and leukopenia is presented.
  • Bone marrow examination revealed vacuolated erythroid and myeloid precursors.
  • Serum analysis showed reduced copper and elevated zinc levels, linked to high-dose zinc supplementation.

Findings:

  • Zinc-induced copper deficiency can mimic myelodysplasia or vitamin B12 deficiency.
  • Vacuolated hematopoietic precursors in bone marrow are crucial diagnostic clues.
  • Anemia and neutropenia can result from impaired copper absorption due to excess zinc.

Implications:

  • Considering copper deficiency is vital for patients with unexplained anemia and neutropenia.
  • Early diagnosis prevents ineffective treatments for conditions like myelodysplasia.
  • Understanding the link between zinc and copper metabolism aids in managing nutritional anemias.