Zinc-induced copper deficiency in an infant.

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.