Element of caution: a case of reversible cytopenias associated with excessive zinc supplementation

Abstract

Zinc is a common supplement and is widely available as a standard component of many over-the-counter products. A number of reports have identified an association between excessive zinc intake and severe cytopenia. We report a case of zinc-induced copper deficiency in a young adult to illustrate this under-recognized cause of anemia and neutropenia.

Figures

Fig. 1: Peripheral blood film at presentation, showing macrocytic anemia and neutropenia, with Pelger–Huët nuclear anomaly (note neutrophil with bilobed nucleus [solid arrow]) (Wright–Giemsa stain; х200).

Fig. 2: Bone marrow aspirate, demonstrating extensive vacuolation of erythroid precursor (solid arrow) (May– Grünwald– Giemsa stain; х1000).

Fig. 3: Bone marrow aspirate, demonstrating extensive vacuolation of myeloid precursor (solid arrow) (May–Grünwald– Giemsa stain; х1000).