This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Wasa, M. Articles by Okada, A. Search for Related Content PubMed PubMed Citation Articles by Wasa, M. Articles by Okada, A. Social Bookmarking                         What's this?

Copper Deficiency With Pancytopenia During Total Parenteral Nutrition

Department of Pediatric Surgery, Osaka Prefectural Hospital, Japan

Minoru Satani, MD

Department of Gastroenterological Surgery, Osaka Prefectural Hospital, Japan

Hirofumi Tanano, MD

Department of Pediatric Surgery, Osaka Prefectural Hospital, Japan

Rchiro Nezu, MD

Department of Surgery I, Osaka University Medical School

Yoji Takagi, MD

Department of Pediatric Surgery, Osaka Prefectural Hospital, Japan

Akira Okada, MD

Department of Pediatric Surgery, Osaka Prefectural Hospital, Japan

Anemia and neutropenia are commonly observed hematologic changes in patients with copper (Cu) deficiency, but thrombocytopenia is rarely found. A-69-year-old patient with postoperative small-bowel obstruction underwent laparotomy three times. Because of persistent obstruction, nasoduodenal suction was continued and total parenteral nutrition was instituted. Fifteen months after the initiation of total parenteral nutrition, the patient gradually developed pancytopenia (red blood cell count 222 x 10⁴/mm³, neutrophil count 1254/mm³, and platelet count 9.2 x 10⁴/mm ³). The serum Cu level was 10 µg/dL and the serum ceruloplasmin level was less than 5 mg/dL. After 2 weeks of Cu supplementation in a daily dose of 20 µmol, the serum Cu level increased to 81 µg/dL and the serum ceruloplasmin level to 20 mg/dL. Hematologic values showed a dramatic response: red blood cell count increased to 362 x 10⁴/mm ³, neutrophil count to 4819/mm³, and platelet count to 22.1 x 10⁴/mm³. The improvement of pancytopenia could be attributed to Cu supplementation. This is the first case report of Cu deficiency with pancytopenia during total parenteral nutrition. (Journal of Parenteral and Enteral Nutrition 18:190-192, 1994)

Journal of Parenteral and Enteral Nutrition, Vol. 18, No. 2, 190-192 (1994)
DOI: 10.1177/0148607194018002190


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. von Drygalski and D. A. Andris Anemia After Bariatric Surgery: More Than Just Iron Deficiency Nutr Clin Pract, April 1, 2009; 24(2): 217 - 226. [Abstract] [Full Text] [PDF]

				A.S. Haddad, V. Subbiah, A.E. Lichtin, K.S. Theil, and J.P. Maciejewski Hypocupremia and bone marrow failure Haematologica, January 1, 2008; 93(1): e1 - e5. [Abstract] [Full Text] [PDF]

				N. Kumar Copper Deficiency Myelopathy (Human Swayback) Mayo Clin. Proc., October 1, 2006; 81(10): 1371 - 1384. [Abstract] [Full Text] [PDF]

				Y. Ito, T. Ando, and T. Nabeshima Latent Copper Deficiency in Patients Receiving Low-Copper Enteral Nutrition for a Prolonged Period JPEN J Parenter Enteral Nutr, September 1, 2005; 29(5): 360 - 366. [Abstract] [Full Text] [PDF]

				N. Kumar, M. A. Elliott, J. D. Hoyer, C. M. Harper Jr, J. E. Ahlskog, and R. L. Phyliky "Myelodysplasia," Myeloneuropathy, and Copper Deficiency Mayo Clin. Proc., July 1, 2005; 80(7): 943 - 946. [Abstract] [PDF]

				X. T. Gregg, V. Reddy, and J. T. Prchal Copper deficiency masquerading as myelodysplastic syndrome Blood, July 30, 2002; 100(4): 1493 - 1495. [Abstract] [Full Text] [PDF]

				M. P. Fuhrman, V. Herrmann, P. Masidonski, and C. Eby Pancytopenia after Removal of Copper from Total Parenteral Nutrition JPEN J Parenter Enteral Nutr, November 1, 2000; 24(6): 361 - 366. [Abstract] [PDF]

				J. E. Spiegel and R. F. Willenbucher Rapid Development of Severe Copper Deficiency in a Patient With Crohn's Disease Receiving Parenteral Nutrition JPEN J Parenter Enteral Nutr, May 1, 1999; 23(3): 169 - 172. [Abstract] [PDF]