Copper-induced Haemolytic Anaemia
  • Joana Azevedo Carvalho
    Hospital Prof. Dr. Fernando Fonseca – Medicina IV, Amadora, Portugal
  • Leonor Boavida
    Hospital Prof. Dr. Fernando Fonseca – Medicina IV, Amadora, Portugal
  • Ricardo Ferreira
    Hospital Prof. Dr. Fernando Fonseca – Oncologia, Amadora, Portugal
  • Catarina Favas
    Hospital Prof. Dr. Fernando Fonseca – Medicina IV, Amadora, Portugal
  • José Delgado Alves
    Hospital Prof. Dr. Fernando Fonseca – Medicina IV, Amadora, Portugal


Copper poisoning, non-immune haemolytic anaemia, toxicology


Acute copper toxicity is uncommon in Western countries and is often the result of accidental consumption or a suicide attempt. We report the case of a 65-year-old man presenting to the accident and emergency department after a suicide attempt with ingestion of Bordeaux mixture, ibuprofen, acetaminophen and bleach. Primary evaluation showed caustic oesophagitis, toxic hepatitis and acute renal injury, which were treated with supportive care. During admission, he developed a non-immune haemolytic anaemia associated with high levels of copper in urine and blood. Chelation treatment with penicillamine was started and evolution was favourable after 1 month of treatment. Copper poisoning can be lethal. Prompt diagnosis and treatment are key for a favourable prognosis.



  • Agrios GN. Control of plant diseases. In: Plant pathology. 5th ed. Amsterdam: Elsevier; 2005, chapter 9.
  • Sonal Sekhar M, Rao M. Clinical toxicology of copper: source, toxidrome, mechanism of toxicity, and management. In: Bagchi D, Bagchi M, editors. Metal toxicology handbook. Boca Raton: CRC Press; 2020, pp. 199–217.
  • Moussiegt A, Ferreira L, Aboab J, Silva D. She has the blues: an unusual case of copper sulphate intoxication. EJCRIM 2020;7(2):001394.
  • Higny J, Vanpee D, Boulouffe C. Bluish vomiting: a rare clinical presentation of poisoning. Acta Clin Belg 2014;69(4):299–301.
  • Royer A, Sharman T. Copper toxicity. [Updated 2021 Apr 3]. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Available from:
  • Saravu K, Jose J, Bhat M, Jimmy B, Shastry B. Acute ingestion of copper sulphate: a review on its clinical manifestations and management. Indian J Crit Care Med 2007;11:74–80.
  • World Health Organization. Suicide. Available from: (accessed 14 July 2021).
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    Published: 2021-10-08
    Issue: 2021: Vol 8 No 9 (view)

    How to cite:
    Azevedo Carvalho J, Boavida L, Ferreira R, Favas C, Delgado Alves J. Copper-induced Haemolytic Anaemia. EJCRIM 2021;8 doi:10.12890/2021_002785.

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