title: Zinc toxicity from massive and prolonged coin ingestion in an adult.
abstract: Acquired copper deficiency anemia is rare in humans. This report describes a 38-year-old schizophrenic man with metal pica, especially coins, who presented with symptomatic anemia. Two hundred seventy-five coins were surgically removed from the gastrointestinal tract of this patient during the course of his hospitalization. Some of the post-1981 pennies, which consist primarily of zinc, showed severe corrosion because of their prolonged contact with acidic gastric juice. The patient presented with clinical manifestations consistent with the local corrosive as well as the systemic effects of zinc intoxication. His treatment and outcome are presented. The effects of zinc intoxication on hematologic and other organ systems and on copper absorption are discussed.
authors.affiliation: Division of Gastroenterology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. spawa@med.wayne.edu
authors.forename: Swati
authors.initials: S
authors.lastname: Pawa
authors.forename: Ahmad J
authors.initials: AJ
authors.lastname: Khalifa
authors.forename: Murray N
authors.initials: MN
authors.lastname: Ehrinpreis
authors.forename: Charles A
authors.initials: CA
authors.lastname: Schiffer
authors.forename: Firdous A
authors.initials: FA
authors.lastname: Siddiqui
mesh_terms: D000740:Anemia / Q000209:etiology; D003300:Copper / Q000172:deficiency*; D005547:Foreign Bodies / Q000150:complications; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009717:Numismatics; D010842:Pica / Q000150:complications; D012559:Schizophrenia / Q000150:complications; D015032:Zinc / Q000633:toxicity*
chemical_list: D003300:Copper; D015032:Zinc