"Myelodysplasia," myeloneuropathy, and copper deficiency.
We describe a patient with a suspected myelodysplastic syndrome that developed in association with a neurologic disorder resembling subacute combined degeneration but without vitamin B12 deficiency. Ultimately, the hematologic manifestations and the neurologic syndrome were linked to severe copper deficiency. Prompt and complete reversal of the hematologic abnormalities occurred with copper replacement. Serum copper determination should be included in the work-up of patients with anemia and leukopenia of unclear etiology who have associated myeloneuropathy. The hematologic picture can resemble sideroblastic anemia or myelodysplastic syndrome. Hyperzincemia can be an accompanying abnormality even without exogenous zinc ingestion. The reason for the copper deficiency may not be evident.
Kumar
Neeraj
N
Department of Neurology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA. kumar.neeraj@mayo.edu
Elliott
Michelle A
MA
Hoyer
James D
JD
Harper
Charles M
CM
Ahlskog
J Eric
JE
Phyliky
Robert L
RL
D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology; D003300:Copper / Q000008:administration & dosage / Q000172:deficiency*; D003677:Deficiency Diseases / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology*; D018908:Muscle Weakness / Q000209:etiology*; D009190:Myelodysplastic Syndromes / Q000209:etiology; D009460:Neurologic Examination; D034941:Upper Extremity; D015032:Zinc / Q000097:blood
D003300:Copper; D015032:Zinc