Zinc sulfate
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Myelodysplastic syndrome and peripheral neuropathy: case report A woman with Wilson’s disease was treated with zinc sulfate and developed myelodysplastic syndrome (MDS) and peripheral neuropathy. The woman had been diagnosed in 1975 aged 27 years. She began receiving oral zinc sulfate 600 mg/day. At 40 years of age, she developed severe limb dystonia. Her zinc sulfate dosage was slowly increased to 1200 mg/day, and she was clinically stable for 10 years. At 51 years of age, after an episode of psychogenic anorexia, the woman had significant weight loss, paleness, asthenia, paresthesia and sensory loss, with impaired hand function and feet drop. On examination, she had tremor, nearly fixed posture of all four limbs, muscle wasting and weakness; her deep tendon reflexes were absent and all sensory modalities were abnormal. Bone marrow biopsy suggested MDS. Retrospective review of her laboratory results over the previous 3 years showed progressive anaemia, with reduction of her copper serum level and urinary excretion rate. Copper deficiency syndrome was suspected. The woman’s zinc sulfate dosage was reduced, then later replaced with zinc acetate. She received blood transfusions and her haematological abnormalities resolved, but her neuropathy did not improve. Cortese A, et al. Copper deficiency in Wilson’s disease: Peripheral neuropathy and myelodysplastic syndrome complicating zinc treatment. Movement Disorders 26: 1361-1362, No. 7, Jun 2011. Available from: URL: http://dx.doi.org/10.1002/ 803058680 mds.23520 - Italy
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Reactions 13 Aug 2011 No. 1364
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