Zinc-induced hypocupremia and pancytopenia, from zinc supplementation to its toxicity, a case report

Wahab, Ahsan; Mushtaq, Kamran; Khan, Aqsa; Khakwani, Muhammad Shahzeb Khan; Masood, Adeel; Henderson, J.L.; Malik, Faizan

doi:10.1080/20009666.2021.1983319

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Further, there is a multitude of studies that report zinc-containing denture cream as a cause, which may be particularly concerning especially in the elderly population [ 8 , 15 ]. Although the inciting event leading to zinc-induced hypocupremia may differ, the literature suggests that most patients have either normocytic or macrocytic anemia (often in addition to neutropenia and/or leukopenia) with or without neurological deficit [ 6 , 8 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…These findings have led to the inclusion of zinc in popular OTC cold medications as well as increased sales of zinc supplements, with the global market expected to double by 2030 [ 5 ]. In the United States, a large majority of users of zinc supplementation are those 71 years and older, who favor it due to the suggested anti-inflammatory/oxidant effects and prevention of neurodegeneration [ 6 ]. Although there are noted benefits to supplementation, there are a relatively small number of reports that describe zinc over supplementation in the elderly leading to hypocupremia [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Zinc-Induced Copper Deficiency as a Rare Cause of Neurological Deficit and Anemia

Gupta,

Carmichael

2023

Cureus

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Upper respiratory infections (URIs) are common and carry a large economic burden due to missed work and school. This has prompted an increased interest in over-the-counter zinc supplementation to enhance immunity and reduce illness duration. Zinc's antiviral and anti-inflammatory effects have led to its inclusion in popular URI medications and a surge in supplement sales, particularly among the elderly. However, zinc over-supplementation in this population can lead to hypocupremia, causing various presentations such as anemia, paresthesia, and gait disturbances. Here, we present a case of a 76-year-old female who developed hypocupremia due to zinc supplementation. Her initial presentation involved an unsteady gait, and severe anemia was detected during the examination. The patient's condition required hospital admission, and subsequent investigations confirmed severe pancytopenia and low blood copper levels. Discontinuation of zinc supplementation and oral copper gluconate administration led to a full recovery of her anemia and cell count; however, her neurological deficits remain. This case highlights the importance of counseling patients on the potential adverse effects of zinc supplementation and brings to light a potentially overlooked diagnosis, particularly in the elderly population.

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