title: Toxic effects associated with consumption of zinc.
abstract: A 27-year-old man with a history of acne presented to his primary care physician because of fatigue and dyspnea on exertion of 4 weeks' duration. He was remarkably pale, orthostatic pulse changes were noted, and a systolic ejection murmur was heard. The patient had profound anemia (hemoglobin concentration, 5.0 g/dL) and neutropenia (neutrophil count, 0.06 x 10(9)/L); he was admitted for further evaluation. A detailed inquiry into his medication history revealed that he was taking several vitamins and zinc gluconate, 850 to 1000 mg/d for 1 year (US recommended daily allowance, 15 mg), as therapy for acne. A zinc toxic and copper-deficient state was confirmed by laboratory studies. The patient was treated with intravenous copper sulfate, followed by 3 months of oral therapy. The complete blood cell count, serum copper level, and serum zinc level returned to normal.
authors.affiliation: Department of Medicine, Univeristy of Chicago, IL, USA. pigic1@uchospitals.edu
authors.forename: Petar G
authors.initials: PG
authors.lastname: Igic
authors.forename: Edward
authors.initials: E
authors.lastname: Lee
authors.forename: William
authors.initials: W
authors.lastname: Harper
authors.forename: Keith W
authors.initials: KW
authors.lastname: Roach
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy; D000328:Adult; D000747:Anemia, Hypochromic / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D003300:Copper / Q000172:deficiency*; D019327:Copper Sulfate / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D015032:Zinc / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D003879:Dermatologic Agents; D003300:Copper; D015032:Zinc; D019327:Copper Sulfate