title: Pancytopenia with myelodysplasia due to copper deficiency.
abstract: We present a case of pancytopenia in a 9-month-old infant with total parenteral nutrition (TPN) dependence due to short bowel syndrome. Bone marrow examination revealed left-shifted myeloid maturation, erythroid and myeloid dysplasia with normal iron stores. Serum copper level was 2 microm/dl (normal range 90-190 mcg/dl). After supplementation, copper levels normalized at 143 mcg/dl, and the macrocytic anemia, neutropenia, and thrombocytopenia resolved. Copper deficiency should be considered in the differential diagnosis of cytopenias and myelodsyplasia, particularly in the growing number of pediatric patients with TPN dependency or malabsorption.
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Angotti
authors.forename: Ginell R
authors.initials: GR
authors.lastname: Post
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Robinson
authors.forename: Jocelyn A
authors.initials: JA
authors.lastname: Lewis
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Hudspeth
authors.forename: John
authors.initials: J
authors.lastname: Lazarchick
mesh_terms: D003300:Copper / Q000172:deficiency*; D020345:Enterocolitis, Necrotizing / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009436:Neural Tube Defects / Q000209:etiology*; D010198:Pancytopenia / Q000209:etiology*; D010289:Parenteral Nutrition, Total; D012778:Short Bowel Syndrome / Q000503:physiopathology
chemical_list: D003300:Copper