title: Copper deficiency during parenteral nutrition: a report of four pediatric cases.
abstract: The standard of care for patients with cholestasis (direct bilirubin >or=2 mg/dL) while receiving parenteral nutrition (PN) solutions is to reduce or discontinue the copper and manganese. The repercussions of this action have not been studied. Two adult case reports document low serum copper levels associated with clinical symptoms of copper deficiency after the removal of copper from their PN solutions. We now describe the first known series of pediatric patients to develop copper deficiency after copper was removed from their PN solutions.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Lucile Salter Packard and Children's Hospital, Stanford University, Palo Alto, CA, USA. mhurwitz@pol.net
authors.forename: Melissa
authors.initials: M
authors.lastname: Hurwitz
authors.forename: Manuel G
authors.initials: MG
authors.lastname: Garcia
authors.forename: Robert L
authors.initials: RL
authors.lastname: Poole
authors.forename: John A
authors.initials: JA
authors.lastname: Kerner