Two patients with sideroblastic anemia secondary to zinc-induced copper deficiency absorbed excess zinc secondary to oral ingestion. The source of excess zinc was a zinc supplement in one case; in the other, ingested coins. In each case, the sideroblastic anemia was corrected promptly after removal of the source of excess zinc. These two cases emphasize the importance of recognizing this clinical entity, since the myelodysplastic features are completely reversible.
Broun ER, Greist A, Tricot G, Hoffman R. Excessive Zinc IngestionA Reversible Cause of Sideroblastic Anemia and Bone Marrow Depression. JAMA. 1990;264(11):1441-1443. doi:10.1001/jama.1990.03450110087033