Author
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Klevay, Leslie |
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Submitted to: Journal of Laboratory and Clinical Medicine
Publication Type: Other Publication Acceptance Date: 5/29/2001 Publication Date: 8/1/2001 Citation: Klevay, L.M. 2001. Letter to editor (Brewer). Journal of Laboratory and Clinical Medicine. 138:214. Interpretive Summary: Technical Abstract: Brewer et al. described their experience in using zinc to remove copper from pediatric patients with Wilson's disease. Treatment of this disease with zinc generally is effective and safe as they and others have shown for older patients. They suggested their dose of zinc for younger children is tentative and that overtreatment must be avoided. The potentially adverse decrease in the HDL/cholesterol ratio found in children but not adults may be a subtle index of overtreatment as results are similar to those of Reiser, et al. who induced lipoprotein change in men depleted of copper. Young pigs fed a diet high in zinc had decreased copper in heart and liver, decreased HDL cholesterol, ultrastructural pathology in cardiac muscle and reduced osteocyte activity and osteochondrosis by light microscopy. Women depleted of copper had increased blood pressure during sustained hand grip. None of the subjects of these depletion experiments was anemic. It seems likely that first evidence of clinical copper deficiency may not always be anemia. Proper growth and development require copper with mental development in very young children and bone and connective tissue being quite sensitive to copper deficiency. The modest changes in lipids may be too subtle to be useful in refining the correct dose of zinc. Measurements of brain, cardiac or skeletal function such as computerized scans, Holter cardiograms or dual-energy x-ray absorptiometry may be helpful. |
