ABSTRACT
A 17-year-old patient was referred for medical evaluation because of persistent refractory upper respiratory tract infections. A complete white blood count revealed exogenous bone marrow suppression and anemia, and despite the cessation of antibiotic therapy, symptoms persisted for an additional four weeks. Serologic testing for other infectious etiologies was negative. Symptoms of fatigue and fainting continued for another six months with continued low white blood cell counts and mild granulocyte hypoplasia. Serum copper and ceruloplasmin levels were decreased, less than 10 mcg/dL and 2 mg/dL, respectively. At this evaluation it was discovered that the patient had been self-medicating with a nonprescription zinc preparation (up to 300 mg daily). Serum zinc levels were above normal ranges (199 mcg/dL). Within two month after zinc supplementation was stopped, blood counts were within normal ranges and the symptoms of fatigue and headache had resolved. Follow-up evaluation at 17 months revealed normal ranges for zinc, copper and ceruloplasmin.
