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Zinc Toxicity Following Massive Coin Ingestion

Bennett, Daniel R. M.D.; Baird, Curtis J. M.D., Ph.D.; Chan, Kwok-Ming Ph.D.; Crookes, Peter F. M.D.; Bremner, Cedric G. M.D.; Gottlieb, Michael M. M.D.; Naritoku, Wesley Y. M.D., Ph.D.

The American Journal of Forensic Medicine and Pathology: June 1997 - Volume 18 - Issue 2 - p 148-153
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This is the first reported case of human fatality associated with zinc intoxication following a massive ingestion of coins. Four hundred and sixty-one coins were removed from the gastrointestinal tract of a schizophrenic patient during the course of hospitalization. Many of the post-1981 pennies, which consist primarily of zinc, showed severe corrosion due to their prolonged contact with acidic gastric juice. The patient presented with clinical manifestations consistent with the local corrosive as well as systemic effects of zinc intoxication and died 40 days after admission with multi-system organ failure. Tissue samples of the kidneys, pancreas, and liver obtained at autopsy revealed acute tubular necrosis, mild fibrosis, and acute massive necrosis, respectively, and contained high levels of zinc. The overall effects of zinc intoxication on the various organ systems, possible hematological derangement, and the impairment of copper absorption as well as the outcome with treatment are discussed.

From the Departments of Pathology (D.R.B., C.J.B., K.M.C., W.Y.N.) and Surgery (P.F.C., C.G.B., M.M.G.), Los Angeles County-University of Southern California Medical Center, Los Angeles, California, U.S.A.

Received October 13, 1995; accepted November 28, 1995.

Address correspondence and reprint requests to Dr. Daniel R. Bennett, Department of Pathology, LAC-USC Medical Center, Room 2900, 1200 North State St., Los Angeles, CA 90033, U.S.A.

© Lippincott-Raven Publishers