Lang and colleagues1 describe a patient with Wilson's disease who deteriorated and died after the initiation of treatment with zinc salts. They refute the claim by Hoogenraad and Van Hattum2 that zinc therapy is never associated with a worsening of neurological signs. Such a claim is, of course, unfounded.3,4 A patient recently referred to us amply illustrates this point.
Report of a Case.
A 19-year-old Indian woman had an elder sister who had died of intractable vomiting at the age of 8 years. At the same age, our patient had an attack of vomiting that abated spontaneously but continued intermittently thereafter. When she was 17 years old, the vomiting became worse and was soon followed by dribbling, dysarthria, tremor, and mild dyskinesia with occasional outbursts of temper. She was labeled as suffering from parkinsonism and anorexia nervosa. Her condition continued to deteriorate, and finally a diagnosis of
Walshe JM, Munro NAR. Zinc-Induced Deterioration in Wilson's Disease Aborted by Treatment With Penicillamine, Dimercaprol, and a Novel Zero Copper Diet. Arch Neurol. 1995;52(1):10–11. doi:10.1001/archneur.1995.00540250012003
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