Trocello J-M, Hinfray S, Sanda N, Reiner P, El Balkhi S, Fabre C, Poupon J, Woimant F
Centre National de Référence pour la Maladie de Wilson, Hôpital Lariboisière, 2 rue Ambroise-Paré, 75010 Paris, France.
Rev Neurol (Paris). 2011 Jun-Jul;167(6-7):537-40. doi: 10.1016/j.neurol.2010.08.010. Epub 2010 Dec 24.
We report two patients with myelopathy associated with copper deficiency and pancytopenia. Excessive intake of zinc can lead to a severe deficiency of copper reducing the absorption of ingested copper. The patients had in common consumption of denture adhesive paste containing zinc. In both patients, laboratory tests showed a combination of copper deficiency, hyperzincemia and increased urinary zinc level. The use of a denture cream was stopped. Copper supplementation, initially subcutaneously then oral corrected the copper deficiency and pancytopenia. Clinically, the pain faded but the gait disturbance persisted. Copper deficiency associated with the use of denture cream rich in zinc is an unrecognized cause of myelopathy associated with pancytopenia which should be diagnosed early to establish appropriate therapeutic measures to minimize neurological complications.
我们报告了两名患有与铜缺乏和全血细胞减少相关的脊髓病的患者。过量摄入锌会导致严重的铜缺乏,从而减少摄入铜的吸收。这两名患者都有共同的使用含锌假牙黏附剂糊剂的情况。在两名患者中,实验室检查均显示铜缺乏、高锌血症和尿锌水平升高。停用了假牙乳膏。补充铜,最初是皮下注射,然后口服,纠正了铜缺乏和全血细胞减少。临床上,疼痛减轻,但步态障碍持续存在。与使用富含锌的假牙乳膏相关的铜缺乏是与全血细胞减少相关的脊髓病的一个未被认识的病因,应尽早诊断以制定适当的治疗措施,将神经并发症降至最低。