title: Pancytopenia complicated with peripheral neuropathy due to copper deficiency: clinical diagnostic review.
abstract: 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.
authors.affiliation: Division of Hematology, Faculty of Medicine, Kagawa University, Kagawa. oima@med.kagawa-u.ac.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Imataki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Akira
authors.initials: A
authors.lastname: Kitanaka
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Kubota
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishida
authors.forename: Terukazu
authors.initials: T
authors.lastname: Tanaka
mesh_terms: D000369:Aged, 80 and over; D003300:Copper / Q000097:blood / Q000172:deficiency*; D006801:Humans; D008297:Male; D010198:Pancytopenia / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D010523:Peripheral Nervous System Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis*
chemical_list: D003300:Copper