title: Zinc-induced copper deficiency in an infant.
abstract: OBJECTIVE
  To describe the case of a 13-month-old girl who developed copper deficiency as a result of excessive zinc gluconate ingestion.
  
  
  METHODS
  Tertiary care hospital in Syracuse, NY.
  
  
  METHODS
  Cessation of zinc ingestion followed by intravenous and oral copper chloride therapy.
  
  
  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.
authors.affiliation: Department of Pediatrics, State University of New York Health Science Center, NY 13210.
authors.forename: A S
authors.initials: AS
authors.lastname: Botash
authors.forename: J
authors.initials: J
authors.lastname: Nasca
authors.forename: R
authors.initials: R
authors.lastname: Dubowy
authors.forename: H L
authors.initials: HL
authors.lastname: Weinberger
authors.forename: M
authors.initials: M
authors.lastname: Oliphant
mesh_terms: D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology; D001856:Bone Marrow Examination; D002570:Ceruloplasmin / Q000737:chemistry; D003300:Copper / Q000008:administration & dosage / Q000172:deficiency* / Q000627:therapeutic use; D003677:Deficiency Diseases / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D004906:Erythrocyte Count; D005260:Female; D005942:Gluconates / Q000009:adverse effects*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D009504:Neutrophils / Q000737:chemistry; D011859:Radiography; D012156:Reticulocytes / Q000737:chemistry; D015032:Zinc / Q000097:blood
chemical_list: D005942:Gluconates; D006454:Hemoglobins; D003300:Copper; C028419:cuprous chloride; D002570:Ceruloplasmin; D015032:Zinc; C030691:gluconic acid