Zinc-induced copper deficiency in an infant
A. S. Botash, J. Nasca, R. Dubowy, H. L. Weinberger and M. Oliphant
Department 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.
