Combined optic neuropathy and myelopathy secondary to copper deficiency.
We report two patients, both with a history of gastric surgery, who presented with progressive optic neuropathy and myelopathy. The patients' symptoms were initially attributed to vitamin B12 deficiency and/or neuromyelitis optica; however, after the neurologic deficits continued to progress with the use of conventional treatments, further evaluation was initiated, and a severe copper deficiency was revealed. Copper deficiency is a rare cause of progressive optic neuropathy and myelopathy and should be considered in the differential diagnosis. It is crucial to elicit a history of gastric surgery or other risk factors for hypocupremia in those patients undergoing an evaluation for subacute or chronically progressive optic neuropathy or myelopathy.
Pineles
Stacy L
SL
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Wilson
Christina A
CA
Balcer
Laura J
LJ
Slater
Robert
R
Galetta
Steven L
SL
D000328:Adult; D000368:Aged; D003300:Copper / Q000097:blood / Q000172:deficiency*; D004596:Electroretinography; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D008279:Magnetic Resonance Imaging; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology*; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology*; D041623:Tomography, Optical Coherence
D003300:Copper