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

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 tre...

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Published inInternal 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
LanguageEnglish
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
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Abstract 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.
AbstractList 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.
ArticleNumber 9366-22
Author Ishiura, Hiroyuki
Kakumoto, Toshiyuki
Mitsui, Jun
Katsuse, Kazuto
Kobayashi, Satoshi
Toda, Tatsushi
Ueda, Masayuki
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  organization: Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
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Cites_doi 10.1016/B978-0-444-52014-2.00049-5
10.1016/j.gastrohep.2012.03.008
10.1016/S0140-6736(77)90295-1
10.4103/0028-3886.25146
10.1136/jnnp.2009.188896
10.1016/j.pjnns.2014.05.002
10.1016/j.trsl.2010.08.007
10.1002/mus.21425
10.1258/0004563041731556
10.1212/WNL.0b013e318219fac8
10.1002/mds.23520
10.1136/adc.60.7.652
10.1016/S0140-6736(89)90612-0
10.1007/s00415-013-6963-6
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Issue 7
Keywords dysphagia
myeloneuropathy
macrocytic anemia
Wilson's disease
copper deficiency
Language English
License The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Correspondence to Dr.　Jun Mitsui, mituij-tky@umin.ac.jp
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SubjectTerms 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
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Title Copper Deficiency in Wilson's Disease with a Normal Zinc Value
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