Excessive zinc ingestion: a reversible cause of sideroblastic anemia and bone marrow depression

Article Abstract:

Zinc and copper compete for absorption by the small intestine. Patients with an elevated zinc load can consequently develop a copper deficiency, which is known to cause both a decreased production of red blood cells (anemia), and a depression of specific white blood cells that are required for protection from infections. Two case studies illustrate the reversible anemias that can result from increased ingestion of zinc. The first case involved a 31-year-old white man who was seen in the emergency room with nausea, vomiting and abdominal pain. Upon X-ray examination a large number of coins (totaling $22.50) were identified and surgically removed. The patient had been diagnosed as a paranoid schizophrenic and had ingested the coins in the belief that they were protective. Following the surgery his anemia and documented copper deficiency rapidly resolved. The second case was a 48-year-old white man seen with a six-month history of fatigue. His blood and marrow samples clearly demonstrated a decreased rate of red blood cell production and a pattern of blood cells that is associated with heavy metal poisoning. Upon questioning the patient indicated that he had been taking daily dietary zinc supplementation. His serum zinc levels were found to be elevated, but copper was not measured. He stopped taking zinc and two weeks later his blood profile had markedly improved. Follow-up examination of his bone marrow showed a rapid return to normal status. Both cases illustrate the toxic effect of ingested zinc. It should be noted that United States pennies minted after October 1982 are composed of 97.6 percent zinc covered by copper. In the case of the patient who swallowed coins, the copper coating was removed by stomach acid and the exposed zinc was responsible for the zinc intoxication. (Consumer Summary produced by Reliance Medical Information, Inc.)

Zinc in the body, Zinc (Nutrient), Copper

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Hematologic neoplasia associated with primary mediastinal germ-cell tumors

Article Abstract:

Germ-cell tumors develop in the sexual reproductive cells, the eggs or sperm. Hematologic neoplasia, cancer of the blood cells, can be associated with mediastinal germ-cell tumors. A review of 16 case studies of patients with hematologic cancer associated with mediastinal germ-cell tumors suggested that the hematologic cancer was not due to the cisplatin-based chemotherapy given for the germ-cell tumors. Further analysis revealed that the hematological cancers were found in patients with mediastinal germ-cell tumors other than those of the testis; these cancers were more likely to be associated with mediastinal germ-cell tumors containing embryonic yolk-sac elements. There was a median period of five months between diagnoses (half of the patients were diagnosed with hematologic cancer five months after their germ-cell cancer diagnosis). The most common hematologic cancers were acute megakaryoblastic leukemia, leukemia of the precursor cells to platelets (which are involved in blood clotting), and malignant histiocytosis, a cancer of undifferentiated primitive cells. The hematologic cancers were extremely virulent and treatment was not successful. The chromosomes of the patients were examined and abnormalities were found, but the findings were not consistent among patients. In one patient, an identical marker was found in both the mediastinal germ-cell tumor and the leukemic blast cells, suggesting that the tumors may have developed from a common cell, a germ cell that could differentiate to various types of cells, including both types of cancerous cells. This study demonstrates that malignant hematopoietic cancers can be associated with mediastinal germ-cell tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Germ cell tumors, Germinoma, Human chromosome abnormalities

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Runner's Anemia

Article Abstract:

Runner's anemia is a type of anemia caused by an increase in blood volume rather than a substantial decrease in red blood cells. However, some blood cells are destroyed by the constant pounding of the feet against the ground. The increase in blood volume seems to be a mechanism for delivering oxygen efficiently.

Runners (Sports)

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