Zinc-induced copper deficiency in a coin swallower

In humans, acquired copper deficiency anemia is rare. This report describes a 58-yr-old man with metal pica, especially coins, who presented with symp tomatic anemia. His workup led to the diagnosis of zinc-induced copper defi ciency. We believe that, in this man, leaching of zinc from pennies explain ed the clinical and laboratory findings. This case demonstrates that health care workers should consider the possibility of zinc-induced copper defici ency when confronted with patients with unexplained anemia who have ingeste d coins or other zinc-containing metals. (Am J Gastroenterol 2000;95:2975-2 977. (C) 2000 by Am. Coll. of Gastroenterology).