Correspondance: Vilhjalmur Steingrimsson, vilhjalmur.steingrimsson@regionstockholm.se

 

Key words: copper deficiency, zinc toxicity, denture adhesive, myelodysplasia mimic, bone marrow failure, neuropathy

 

Copper deficiency is a rare and often overlooked cause of anemia, neutropenia, and neuropathy. We describe a case where a 47-year-old man sought medical attention because of weight loss, fatigue, and neurological symptoms. Initial evaluation suggested myelodysplastic syndrome, with anemia and neutropenia. Furthermore, the bone marrow was hypercellular with prominent cytoplasmic vacuoles in myeloid precursors. Subsequently, the clinical picture was determined to result from severe copper deficiency secondary to excessive zinc exposure. Further history revealed long-term use of a zinc-containing denture adhesive. After copper supplementation and discontinuation of the adhesive, blood status normalized and symptoms largely resolved. This case highlights the importance of considering copper deficiency in unexplained bone marrow failure.