一分钱换你的想法：同一患者因锌诱导的铜缺乏导致全血细胞减少的病例系列
Pennies for Your Thoughts: A Case Series of Pancytopenia Due to Zinc-induced Copper Deficiency in the Same Patient.
作者信息
Dolcourt Bram A, Paxton James H, Bora Keenan M, Aaron Cynthia K
机构信息
Wayne State University, Department of Emergency Medicine, Detroit, Michigan.
出版信息
Clin Pract Cases Emerg Med. 2019 Oct 14;3(4):341-344. doi: 10.5811/cpcem.2019.7.43697. eCollection 2019 Nov.
A 47-year-old schizophrenic male presented on three separate occasions with pancytopenia and sideroblastic anemia due to copper deficiency from massive zinc penny ingestion. The poisoning was treated differently on each visit: intravenous (IV) copper plus surgical decontamination and chelation with calcium disodium versenate (CaNa2EDTA); IV copper plus whole bowel irrigation; and IV copper with surgical decontamination only. Serum zinc half-lives were 80.0 hours, 233.2 hours, and 83.9 hours, respectively. Importantly, chelation with CaNa2EDTA did not significantly alter the elimination half-life. This is the first reported case of the same patient being treated on three different occasions with three different regimens for this condition.
一名47岁的精神分裂症男性患者，因大量吞食含锌便士导致铜缺乏，三次出现全血细胞减少和铁粒幼细胞贫血。每次就诊时对中毒的治疗方法不同：静脉注射（IV）铜加手术去污及用依地酸钙钠（CaNa2EDTA）螯合；静脉注射铜加全肠道灌洗；以及仅静脉注射铜加手术去污。血清锌半衰期分别为80.0小时、233.2小时和83.9小时。重要的是，用CaNa2EDTA螯合并未显著改变消除半衰期。这是首例报道同一患者针对该病症在三个不同场合接受三种不同治疗方案的病例。
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