Carvalho Joana A, Boavida Leonor, Ferreira Ricardo, Favas Catarina, Delgado Alves José
Hospital Prof. Dr. Fernando Fonseca - Medicina IV, Amadora, Portugal.
Hospital Prof. Dr. Fernando Fonseca - Oncologia, Amadora, Portugal.
Eur J Case Rep Intern Med. 2021 Sep 7;8(9):002785. doi: 10.12890/2021_002785. eCollection 2021.
Acute copper toxicity is uncommon in Western countries and is often the result of accidental consumption or a suicide attempt. We report the case of a 65-year-old man presenting to the accident and emergency department after a suicide attempt with ingestion of Bordeaux mixture, ibuprofen, acetaminophen and bleach. Primary evaluation showed caustic oesophagitis, toxic hepatitis and acute renal injury, which were treated with supportive care. During admission, he developed a non-immune haemolytic anaemia associated with high levels of copper in urine and blood. Chelation treatment with penicillamine was started and evolution was favourable after 1 month of treatment. Copper poisoning can be lethal. Prompt diagnosis and treatment are key for a favourable prognosis.
Acute copper intoxication is rare and early clinical suspicion and diagnosis are essential to reduce mortality.The diagnosis of copper poisoning should be based on clinical presentation and measurement of urine and blood copper levels in addition to serum ceruloplasmin levels.Treatment includes reduction of absorption, supportive measures, management of complications and chelation therapy.
急性铜中毒在西方国家并不常见，通常是意外摄入或自杀未遂的结果。我们报告一例65岁男性，在自杀未遂时摄入波尔多液、布洛芬、对乙酰氨基酚和漂白剂后就诊于急诊科。初步评估显示有腐蚀性食管炎、中毒性肝炎和急性肾损伤，给予支持治疗。住院期间，他出现了与尿液和血液中高铜水平相关的非免疫性溶血性贫血。开始用青霉胺进行螯合治疗，治疗1个月后病情好转。铜中毒可能致命。及时诊断和治疗是预后良好的关键。
急性铜中毒罕见，早期临床怀疑和诊断对于降低死亡率至关重要。铜中毒的诊断应基于临床表现以及尿液和血液铜水平的测定，此外还需测定血清铜蓝蛋白水平。治疗包括减少吸收、支持措施、并发症处理和螯合疗法。
