{"id":"685fd902-096b-5e44-bbaa-a34d5d913aac","stable_key":"6d38d43e-01e4-5641-93be-65654271e242:zn-clin-hypocupremia","predicate":"prolonged_treatment_associated_with_low","statement":"An adult with sickle cell anemia developed hypocupremia after two years of zinc therapy, accompanied by microcytosis and relative neutropenia. Additional zinc-treated patients had varying hypoceruloplasminemia.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"negative","is_public":true,"mechanism_event_id":"6639ff49-3b92-5a63-905a-a3afe73eb787","mechanism_event_label":"Long zinc treatment was associated with copper shortage and blood-cell changes.","subject":{"id":"0429f0ff-c033-514b-9a4f-6f0f83268095","slug":"zinc","display_name":"Zinc","entity_type_key":"nutrient_element"},"object":{"id":"db7bc59e-c019-5547-a007-d0d77633bf00","slug":"plasma-copper-concentration","display_name":"Plasma copper concentration","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"6639ff49-3b92-5a63-905a-a3afe73eb787","stable_key":"6d38d43e-01e4-5641-93be-65654271e242:zn-clin-hypocupremia-event","event_type":"observed_intervention","label":"Long zinc treatment was associated with copper shortage and blood-cell changes.","description":"An adult with sickle cell anemia developed hypocupremia after two years of zinc therapy, accompanied by microcytosis and relative neutropenia. Additional zinc-treated patients had varying hypoceruloplasminemia.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"9f0afdde-1ec1-5c8a-bb5e-f3b2b75f67f6","slug":"copper","display_name":"Copper","entity_type_key":"nutrient_element"},"role":"deficient_nutrient","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"aa4f9545-abea-55c8-ab10-6ec530caa23f","slug":"erythrocyte-mean-cell-volume","display_name":"Erythrocyte mean cell volume","entity_type_key":"cellular_process"},"role":"reduced_endpoint","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"8234cc12-509e-5aab-bd0d-d31a6ba01000","slug":"blood-neutrophil-count","display_name":"Blood neutrophil count","entity_type_key":"cellular_process"},"role":"reduced_endpoint","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"52c51470-f6c6-55ad-8d48-21de3c6799d7","slug":"serum-ceruloplasmin-concentration","display_name":"Serum ceruloplasmin concentration","entity_type_key":"cellular_process"},"role":"associated_marker","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""},{"entity":{"id":"0429f0ff-c033-514b-9a4f-6f0f83268095","slug":"zinc","display_name":"Zinc","entity_type_key":"nutrient_element"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":4,"notes":""},{"entity":{"id":"db7bc59e-c019-5547-a007-d0d77633bf00","slug":"plasma-copper-concentration","display_name":"Plasma copper concentration","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":5,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"cross_nutrient","value_text":"Copper (deficient_nutrient); Erythrocyte mean cell volume (reduced_endpoint); Blood neutrophil count (reduced_endpoint); Serum ceruloplasmin concentration (associated_marker)","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"evidence_location","value_text":"Indexed primary abstract.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/zinc-clinical-sources/prasad1978.abstract.txt\", \"locator\": \"Primary indexed abstract; complete local file\", \"file_sha256\": \"7c4b85a9dd24c3e3bfd04414c0add5d0fa2bcc8c15b5e46bded351e2a2f01e3f\", \"utf8_bytes\": 487}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Clinical case and additional observations in adults with sickle cell anemia receiving zinc therapy","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Index patient received zinc as an antisickling intervention for two years; copper was subsequently administered.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Case evidence in a particular disease setting; dose and formulation are not verified from the abstract. Does not establish incidence or a universal zinc:copper supplement ratio.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Zinc research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"zinc","display_name":"Zinc","entity_type_key":"nutrient_element"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"Long zinc treatment was associated with copper shortage and blood-cell changes.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[zn-clin-prasad1978] Hypocupremia induced by zinc therapy in adults. (1978). https://pubmed.ncbi.nlm.nih.gov/359844/ DOI: 10.1001/jama.1978.03290200044019","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Blood copper and hematology","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"9dccc40f-5e4f-5178-a4b0-aa6870be584e","evidence_kind":"source_excerpt","locator":"Lines 1407-1420","start_line":1407,"end_line":1420,"excerpt":"### zn-clin-hypocupremia\nAn adult with sickle cell anemia developed hypocupremia after two years of zinc therapy, accompanied by microcytosis and relative neutropenia. Additional zinc-treated patients had varying hypoceruloplasminemia.\nCondition category: nutrient_deficiency\nnutrient_topic: Zinc research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Long zinc treatment was associated with copper shortage and blood-cell changes.\norganism: Homo sapiens\ntissue_or_cell_type: Blood copper and hematology\nexperimental_model: Clinical case and additional observations in adults with sickle cell anemia receiving zinc therapy\nlimitations: Case evidence in a particular disease setting; dose and formulation are not verified from the abstract. Does not establish incidence or a universal zinc:copper supplement ratio.\nexposure: Index patient received zinc as an antisickling intervention for two years; copper was subsequently administered.\ncross_nutrient: Copper (deficient_nutrient); Erythrocyte mean cell volume (reduced_endpoint); Blood neutrophil count (reduced_endpoint); Serum ceruloplasmin concentration (associated_marker)\nevidence_location: Indexed primary abstract.\nevidence_span: {\"source_cache\": \"artifacts/zinc-clinical-sources/prasad1978.abstract.txt\", \"locator\": \"Primary indexed abstract; complete local file\", \"file_sha256\": \"7c4b85a9dd24c3e3bfd04414c0add5d0fa2bcc8c15b5e46bded351e2a2f01e3f\", \"utf8_bytes\": 487}\n[zn-clin-prasad1978] Hypocupremia induced by zinc therapy in adults. (1978). https://pubmed.ncbi.nlm.nih.gov/359844/ DOI: 10.1001/jama.1978.03290200044019","model_system":"Clinical case and additional observations in adults with sickle cell anemia receiving zinc therapy","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [zn-clin-prasad1978] Hypocupremia induced by zinc therapy in adults. (1978). https://pubmed.ncbi.nlm.nih.gov/359844/ DOI: 10.1001/jama.1978.03290200044019","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"c5ee0fee-ce5c-58de-905a-10fb0ea0723c","stable_key":"import-6d38d43e-01e4-5641-93be-65654271e242","title":"Zinc: transport, enzyme loading, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"2e731dd54477ec1254e97df3323e1208d38f1375effed19252e71ab4f600d13a","revision_id":"c72258b9-ac09-5408-9d44-a921ad1f96a3","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}