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Case Reports
. 2023 Apr 1;62(7):1073-1076.
doi: 10.2169/internalmedicine.9366-22. Epub 2022 Aug 30.

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

Masayuki Ueda  1 , Kazuto Katsuse  1 , Toshiyuki Kakumoto  1 , Satoshi Kobayashi  1 , Hiroyuki Ishiura  1 , Jun Mitsui  2 , Tatsushi Toda  1
Affiliations
Case Reports

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

Masayuki Ueda et al. Intern Med. .

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.

Keywords: Wilson's disease; copper deficiency; dysphagia; macrocytic anemia; myeloneuropathy.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Jun Mitsui: Research funding, Nobel Pharma.

Figures

Figure.
Figure.
T2-weighted magnetic resonance imaging of the cervical spinal cord. Sagittal (a) and axial (b) views show longitudinal hyperintense lesions in the dorsal column from C1 to C6 (arrows).
See this image and copyright information in PMC

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