ZINC-INDUCED SIDEROBLASTIC ANEMIA - REPORT OF A CASE, REVIEW OF THE LITERATURE, AND DESCRIPTION OF THE HEMATOLOGIC SYNDROME

Zinc ingestion has become increasingly popular in the lay and food fad dist population. Herein described by way of a case report and review o f the 13 cases in the literature is the syndrome of severe anemia asso ciated 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 reve als increased zinc levels, decreased copper levels, and a decrease in ceruloplasmin. The mechanism appears to be zinc-induced copper deficie ncy, which is instrumental in producing the profound bone marrow abnor malities, as zinc itself is of low toxicity. Importantly, the syndrome is totally reversible with cessation of zinc intake. Hematologists sh ould be aware of this form of reversible sideroblastic anemia. (C) 199 4 Wiley-Liss, Inc.