Severe Pancytopenia Secondary to Zinc Toxicity from Age-Related Eye Disease Study Vitamin Supplementation

Purpose: To report a case of zinc-induced hypocupremia associated with Age-Related Eye Disease Study 2 supplementation presenting with pancytopenia. Methods: A single case was retrospectively reviewed. Results: An 86-year-old woman taking Age-Related Eye Disease Study 2 supplementation presented to a hematology-oncology clinic with severe fatigue and pancytopenia. Laboratory evaluation demonstrated elevated zinc levels and low copper levels consistent with zinc-induced hypocupremia. Age-Related Eye Disease Study supplementation was discontinued, and the patient was started on copper supplementation. At the 4-month follow-up, the patient demonstrated near normalization of hematologic parameters and resolution of symptoms. Conclusions: Zinc-induced hypocupremia is a rare but potentially fatal complication of Age-Related Eye Disease Study 2 supplementation and may present with pancytopenia. Clinicians should consider this diagnosis in patients taking zinc-containing supplements who present with unexplained cytopenias.