title: [Peripheral neuropathy, myelopathy, cerebellar ataxia, and subclinical optic neuropathy associated with copper deficiency occurring 23 years after total gastrectomy].
abstract: We report a 61-year-old man with slowly progressive gait disturbance and paresthesia in the lower extremities following a total gastrectomy for gastric cancer 23 years previously. The patient presented with hyperreflexia, peripheral sensory neuropathy, and cerebellar ataxia. Magnetic resonance imaging showed atrophy of the cerebellum, and electrophysiological findings suggested the presence of disorder in both sides of the pyramidal tract, dorsal column, peripheral nerves, and optic nerve. Laboratory findings revealed anemia, neutropenia, and a remarkably low serum copper level (10 microg/dl; normal: 68-128). His serum vitamin E was slightly low and his serum vitamin B12 was within the normal limits. After administering an oral copper supplement, his symptoms improved with normalization of the serum copper level. We need to pay attention to myeloneuropathy caused by copper deficiency if the patient has a past history of total gastrectomy.
authors: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyusyu University.
authors: Meiko
authors: M
authors: Inaba
authors: Takako
authors: T
authors: Torii
authors: Koji
authors: K
authors: Shinoda
authors: Ryo
authors: R
authors: Yamasaki
authors: Yasumasa
authors: Y
authors: Ohyagi
authors: Jun-ichi
authors: J
authors: Kira
mesh_terms: D003300:Copper / Q000172:deficiency; D012628:Dermatitis, Seborrheic / Q000150:complications; D005743:Gastrectomy / Q000009:adverse effects; D006201:Hair Diseases / Q000150:complications; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000209:etiology*; D008297:Male; D008661:Metabolism, Inborn Errors / Q000150:complications; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D011183:Postoperative Complications; D012640:Seizures / Q000150:complications; D013118:Spinal Cord Diseases / Q000209:etiology*; D013274:Stomach Neoplasms / Q000601:surgery; D013997:Time Factors
chemical_list: D003300:Copper