Copper deficiency myelopathy secondary to parenteral zinc supplementation during chronic dialysis

[摘要] Copper deficiency myelopathy secondary to parenteral zinc supplementation during chronic hemodialysis has rarely reported in the literature. An elderly woman presenting with unsteady gait and paresthesia in lower limbs was admitted to our hospital. She has been having chronic renal insufficiency managed with hemodialysis and zinc-supplementation for the past ten years. The neurological examination showed that light touch, vibration, proprioception and the deep tendon reflexes were symmetrically reduced in both lower limbs. The spine-MRI revealed hyperintensity lesions on thoracic segments. The laboratory tests showed anemia, elevated zinc, and reduced copper and ceruloplasmin levels. Zinc- supplementation was discontinued and elemental copper was started. Two weeks later, the patient had a full recovery. In the follow-up six months later, all the laboratory tests were normal and investigations to search for immune suppression, vasculitis, and infection was negative.

[学科分类] 神经科学