Pancytopenia Complicated with Peripheral Neuropathy Due to Copper Deficiency: Clinical Diagnostic Review

• Published in: Internal Medicine Vol. 47; no. 23; pp. 2063 - 2065
• Main Authors: Imataki, Osamu, Ohnishi, Hiroaki, Kitanaka, Akira, Kubota, Yoshitsugu, Ishida, Toshihiko, Tanaka, Terukazu
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2008
• Subjects: Aged, 80 and over; Anemia; Ceruloplasmin; Copper; Copper - blood; Copper - deficiency; Dietary supplements; Etiology; Gastrectomy; Gastric cancer; Humans; Malabsorption; Male; Neutropenia; Pancytopenia; Pancytopenia - blood; Pancytopenia - complications; Pancytopenia - diagnosis; Parenteral nutrition; Peripheral Nervous System Diseases - blood; Peripheral Nervous System Diseases - complications; Peripheral Nervous System Diseases - diagnosis; Peripheral neuropathy; Serum levels; total parenteral nutrition; Trace elements; Zinc
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.47.1323

Only a dozen cases of pancytopenia caused by copper deficiency have been reported. We report the case of an 81-year-old man who underwent total gastrectomy for gastric cancer. He received total parenteral nutrition without trace element supplementation for 6 months. Serum levels of copper and ceruloplasmin were low, but serum zinc was normal. The administration of copper into TPN led to rapid improvement in anemia and neutropenia. We review 11 previous cases of copper-deficient cytopenia, categorized into two groups according to etiology, and define the characteristic symptom of copper malabsorption caused by excess Zn as peripheral neuropathy.