Case Report | Published:

Zinc-induced copper deficiency in a coin swallower

American Journal of Gastroenterology volume 95, pages 29752977 (2000) | Download Citation

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Abstract

In humans, acquired copper deficiency anemia is rare. This report describes a 58-yr-old man with metal pica, especially coins, who presented with symptomatic anemia. His workup led to the diagnosis of zinc-induced copper deficiency. We believe that, in this man, leaching of zinc from pennies explained the clinical and laboratory findings. This case demonstrates that health care workers should consider the possibility of zinc-induced copper deficiency when confronted with patients with unexplained anemia who have ingested coins or other zinc-containing metals.

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References

  1. 1.

    Committee on Dietary Allowances, Food and Nutrition Board, National Research Council. Recommended dietary allowances, 10th ed.. 1989 National Academy Press: Washington, DC.

  2. 2.

    , Copper. In: Mertz W, eds. Trace elements in human and animal nutrition. 5th ed. Academy Press: San Diego, 1987:301–364.

  3. 3.

    , Neonatal copper deficiency. N Engl J Med 1971;285:841–843.

  4. 4.

    Copper deficiency in humans. Semin Hematol 1983;20:118–128.

  5. 5.

    , , , et al. Anaemia and low serum-copper during zinc therapy. Lancet 1977;2:744.

  6. 6.

    , Zinc-induced sideroblastic anemia: Report of a case, review of the literature, and description of the hematologic syndrome. Am Hematol 1994;46:147–150.

  7. 7.

    , , Anemia and neutropenia caused by copper deficiency. Ann Intern Med 1974;80:470–476.

  8. 8.

    , , Intestinal metallothionein and the mutual antagonism between copper and zinc in the rat. J Inorg Biochem 1979;11:57–66.

  9. 9.

    , , , et al. Iron metabolism in copper deficient swine. J Clin Invest 1968;47:2058–2069.

  10. 10.

    , , , et al. Studies in copper metabolism. XIX. The kinetics of iron metabolism and erythrocyte life span in copper deficient swine. J Exp Med 1956;103:701–712.

  11. 11.

    The copper connection. Semin Hematol 1983;20:114–117.

  12. 12.

    US Mint. Specification of US Coins by US Mint, 1989. US Dept. of Treasury: Washington, DC, 1989.

  13. 13.

    , , , et al. Excessive zinc ingestion: A reversible cause of sideroblastic anemia and bone marrow depression. JAMA 1990;264:1441.

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Affiliations

  1. Division of Digestive Diseases and Nutrition, John L. McClellan Memorial Veterans Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    • Hassan A Hassan
    • , Catherine Netchvolodoff
    •  & Jean-Pierre Raufman

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Correspondence to Hassan A Hassan.

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DOI

https://doi.org/10.1111/j.1572-0241.2000.02336.x

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