Copper toxicosis in an Australian child.

A 20 month old Caucasian child living in rural Australia presented with liver failure after exposure from birth to milk formula made from acidic bore water containing excess copper leached from the copper piping. The liver pathology was identical to that seen in Indian childhood cirrhosis and similar disease in non-Indian children now termed idiopathic copper toxicosis (ICT). The only other Australian case, reported more than 20 years previously, had identical presentation, pathology and circumstances of occurrence. The rarity of ICT in Australia, despite a significant population at risk, and the implications of these cases are discussed.