Copper Deficiency in Wilson's Disease with a Normal Zinc Value

• Published in: Internal medicine (Tokyo, 1992) Vol. 62; no. 7; pp. 1073 - 1076
• Main Authors: Ueda, Masayuki, Katsuse, Kazuto, Kakumoto, Toshiyuki, Kobayashi, Satoshi, Ishiura, Hiroyuki, Mitsui, Jun, Toda, Tatsushi
• Format: Journal Article
• Language: English
• Published: Japan Japan Science and Technology Agency 01.04.2023; The Japanese Society of Internal Medicine
• Subjects: Case Report; Copper; Deglutition Disorders; Diarrhea; Dysphagia; Female; Hepatolenticular Degeneration - complications; Hepatolenticular Degeneration - drug therapy; Humans; Internal medicine; Long-Term Care; Middle Aged; Nutrient deficiency; Overdose; Wilson's disease; Zinc; dysphagia; myeloneuropathy; macrocytic anemia; Wilson's disease; copper deficiency
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.9366-22

Copper deficiency (CD) is a rare complication of long-term treatment of Wilson's disease (WD) and is usually accompanied by high serum zinc levels. A 57-year-old woman with WD presented with limb weakness and sensory disturbance due to myeloneuropathy and macrocytic anemia after 36 years of treatment. Markedly reduced serum free copper values confirmed CD, which was considered to be caused by progressive dysphagia and severe diarrhea rather than zinc overdose because of the normal serum zinc levels. Discontinuing copper-reducing therapy and increasing copper intake improved her symptoms. Physicians should be alert for the risk of CD in WD patients, especially those with dysphagia.