The copper conundrum: a case of toxicity and altered mental status in a young male with opioid dependency

Jinal Soni; Vinus Taneja; Pooja Khosla; Rishikesh Dessai

doi:10.18203/2320-6012.ijrms20240229

Authors

Jinal Soni Department of Internal Medicine, Sir Ganga Ram Hospital, Delhi, India
Vinus Taneja Department of Internal Medicine, Sir Ganga Ram Hospital, Delhi, India
Pooja Khosla Department of Internal Medicine, Sir Ganga Ram Hospital, Delhi, India
Rishikesh Dessai Department of Internal Medicine, Sir Ganga Ram Hospital, Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240229

Keywords:

Toxicity, Copper, Opioid, Polyneuropathy

Abstract

Copper is a trace element with higher concentrations in the brain, liver, and kidneys. Its toxicity is rare in humans because of its homeostatic mechanisms. This case highlights a 30-year-old male with a history of opioid abuse and occupational exposure to metallurgy. Despite treatment, a gradual neurological worsening prompted us for heavy metal screening and nerve conduction velocity study (NCV) which revealed copper toxicity and demyelinating polyneuropathy. Following the initiation of D-penicillamine therapy, he showed gradual improvement. The coexistence of opioid abuse and dependency posed challenges in the clinical presentation, necessitating a comprehensive approach to effectively manage both opioid withdrawal and evaluation for other toxic substances.

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