Journal
INTERNAL MEDICINE JOURNAL
Volume 50, Issue 1, Pages 121-123Publisher
WILEY
DOI: 10.1111/imj.14694
Keywords
Wilson disease; zinc; copper; subacute combined degeneration; neurological complication
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A 17-year-old female was diagnosed with Wilson disease and commenced on oral zinc therapy. She re-presented 6 months later with a fall and had classical signs of subacute combined degeneration of the spinal cord confirmed on nerve conduction studies, as a result of zinc-induced copper deficiency. After 6 months of copper therapy, she made a complete recovery with no residual neurological deficits. Early detection of zinc-induced copper deficiency and stringent follow-up mechanisms are crucial. Early initiation of copper replacement may both limit and completely reverse neurological deficits.
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