Fiske D N, McCoy H E, Kitchens C S
Department of Medicine, University of Florida College of Medicine, Gainesville.
Am J Hematol. 1994 Jun;46(2):147-50. doi: 10.1002/ajh.2830460217.
Zinc ingestion has become increasingly popular in the lay and food faddist population. Herein described by way of a case report and review of the 13 cases in the literature is the syndrome of severe anemia associated with excessive and prolonged intake of oral zinc. The syndrome is characterized by anemia, granulocytopenia, and bone marrow findings of vacuolated precursors and ringed sideroblasts. Serum analysis reveals increased zinc levels, decreased copper levels, and a decrease in ceruloplasmin. The mechanism appears to be zinc-induced copper deficiency, which is instrumental in producing the profound bone marrow abnormalities, as zinc itself is of low toxicity. Importantly, the syndrome is totally reversible with cessation of zinc intake. Hematologists should be aware of this form of reversible sideroblastic anemia.
锌摄入在普通人群和追求饮食时尚的人群中越来越普遍。本文通过一例病例报告并回顾文献中的13例病例，描述了与过量长期口服锌摄入相关的严重贫血综合征。该综合征的特征为贫血、粒细胞减少，以及骨髓中出现空泡前体细胞和环形铁粒幼细胞。血清分析显示锌水平升高、铜水平降低以及铜蓝蛋白减少。其机制似乎是锌诱导的铜缺乏，这导致了严重的骨髓异常，因为锌本身毒性较低。重要的是，停止锌摄入后该综合征完全可逆。血液学家应了解这种可逆性铁粒幼细胞贫血的形式。
