Pennies for Your Thoughts: A Case Series of Pancytopenia Due to Zinc-induced Copper Deficiency in the Same Patient

• Published in: Clinical practice and cases in emergency medicine Vol. 3; no. 4; pp. 341 - 344
• Main Authors: Dolcourt, Bram, Paxton, James, Bora, Keenan, Aaron, Cynthia
• Format: Journal Article
• Language: English
• Published: Irvine University of California Digital Library - eScholarship 14-10-2019; University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine; eScholarship Publishing, University of California
• Subjects: Abdomen; Anemia; Case Series; Clinical medicine; Coins; Copper; Emergency medical care; Hospitalization; Hospitals; Laboratories; Medicine; Poisoning; Small intestine; Surgery; Zinc
• ISSN: 2474-252X; 2474-252X
• DOI: 10.5811/cpcem.2019.7.43697

A 47-year-old schizophrenic male presented on three separate occasions with pancytopenia and sideroblastic anemia due to copper deficiency from massive zinc penny ingestion. The poisoning was treated differently on each visit: intravenous (IV) copper plus surgical decontamination and chelation with calcium disodium versenate (CaNa2EDTA); IV copper plus whole bowel irrigation; and IV copper with surgical decontamination only. Serum zinc half-lives were 80.0 hours, 233.2 hours, and 83.9 hours, respectively. Importantly, chelation with CaNa2EDTA did not significantly alter the elimination half-life. This is the first reported case of the same patient being treated on three different occasions with three different regimens for this condition.