# A Hematologic Twist: Zinc-Induced Copper Deficiency Mimicking Myelodysplastic Syndrome

**Authors:** Mary Hinson Mims, Erin S Reid, Mary Grace Hash, Andreas Maddux

PMC · DOI: 10.7759/cureus.87624 · Cureus · 2025-07-09

## TL;DR

This paper discusses a case where excessive zinc intake caused copper deficiency, mimicking a serious blood disorder called myelodysplastic syndrome.

## Contribution

The paper highlights the underdiagnosed condition of zinc-induced copper deficiency and its potential to mimic myelodysplastic syndrome.

## Key findings

- Excessive zinc intake can lead to copper deficiency with symptoms like anemia and neutropenia.
- Zinc toxicity should be considered in diagnosing unexplained blood disorders.
- Post-COVID zinc supplementation increases the risk of this condition.

## Abstract

Zinc-induced copper deficiency is an underdiagnosed condition that can lead to systemic manifestations of hypocupremia, including anemia, neutropenia, ataxic myelopathy, spastic paresis, alopecia, and skin depigmentation. This case illustrates the harmful effects of zinc supplementation and zinc-containing denture adhesive in a 68-year-old man, ultimately leading to copper deficiency. It also underscores the importance of considering zinc toxicity in the differential diagnosis of patients presenting with unexplained cytopenias, bone marrow abnormalities, and related symptoms. Furthermore, this report highlights the need for clinicians to consider zinc toxicity-induced copper deficiency in the evaluation of unexplained pancytopenias, especially in the post-COVID era, where zinc supplementation has become increasingly prevalent.

## Linked entities

- **Chemicals:** zinc (PubChem CID 23994), copper (PubChem CID 23978)
- **Diseases:** myelodysplastic syndrome (MONDO:0018881), anemia (MONDO:0002280), neutropenia (MONDO:0001475), alopecia (MONDO:0004907)

## Full-text entities

- **Genes:** TWIST1 (twist family bHLH transcription factor 1) [NCBI Gene 7291] {aka ACS3, BPES2, BPES3, CRS, CRS1, CSO}
- **Diseases:** skin depigmentation (MESH:D012871), Copper Deficiency (MESH:C535468), toxicity (MESH:D064420), spastic paresis (MESH:D010291), Myelodysplastic Syndrome (MESH:D009190), pancytopenias (MESH:D010198), cytopenias (MESH:D006402), neutropenia (MESH:D009503), COVID (MESH:D000086382), bone marrow abnormalities (MESH:D001855), alopecia (MESH:D000505), ataxic myelopathy (MESH:D013118), anemia (MESH:D000740), hypocupremia (MESH:D007706)
- **Chemicals:** Zinc (MESH:D015032)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12334246/full.md

## References

19 references — full list in the complete paper: https://tomesphere.com/paper/PMC12334246/full.md

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Source: https://tomesphere.com/paper/PMC12334246