Abstract

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.