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Case Reports
. 2013 Jun 30;2(2):132-6.
Print 2013.

Pancytopenia related to dental adhesive in a young patient

Farhard Khimani  1 , Ryan Livengood, Olukemi Esan, Jeffrey A Vos, Vivek Abhyankar, Ludwig Gutmann, William Tse
Affiliations
Case Reports

Pancytopenia related to dental adhesive in a young patient

Farhard Khimani et al. Am J Stem Cells. .

Abstract

Copper deficiency resulting in hypocupremia is a rare cause of pancytopenia associated with a neurological syndrome. Hypocupremia may also occur as a consequence of excessive oral zinc consumption as described by Brewer et al and several other groups. Dental fixatives have been described as a potential source of hyperzincemia in patients. Despite the recently modified dental fixatives with safer zinc content, zinc poisoning results in hypocupremia secondary to inappropriate use of them can still happen and more likely be misdiagnosed. We describe a case of a patient with pancytopenia who was diagnosed with severe aplastic anemia and hypocellular myelodysplastic syndrome and was referred to us for consideration of bone marrow transplantation.

Keywords: Pancytopenia; adhesive; dental.

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Figures

Figure 1
Figure 1
Pre-treatment bone marrow aspirate smear shows vacuolated promyelocytes in a background of erythroid precursors (Wright stain; 1000x).
Figure 2
Figure 2
Pre-treatment bone marrow biopsy is hypocellular with moderate granulocytic hypoplasia and decreased myeloid: erythroid ratio (Hematoxylin and eosin stain; 1000x).
Figure 3
Figure 3
Abnormal erythroid iron incorporation results in many ring sideroblasts such as the one shown from the pre-treatment marrow evaluation (Iron stain; 1000x).
Figure 4
Figure 4
Post-treatment bone marrow aspirate smear shows no residual morphologic abnormalities (Wright stain; 1000x).Figure 4. Post-treatment bone marrow aspirate smear shows no residual morphologic abnormalities (Wright stain; 1000x).
Figure 5
Figure 5
Post-treatment bone marrow biopsy is normocellular with reconstitution of granulocytic lineage and normalization of myeloid: erythroid ratio (Hematoxylin and eosin stain; 1000x).
See this image and copyright information in PMC

References

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