Views: 1,406 | Downloads: 35 | Responses: 0

Case ReportOpen Access

Anemia and Neutropenia in Copper-Deficient Patients: A Report of Two Cases and Literature Review

Hantaweepant C , Chinthammitr Y , Siritanaratkul N

Abstract | Full Text | References | Citation| Response

Close  
Citation

Hantaweepant C, Chinthammitr Y, Siritanaratkul N. Anemia and Neutropenia in Copper-Deficient Patients: A Report of Two Cases and Literature Review. J Med Assoc Thai 2016;99:732.

Copper deficiency is an uncommon, but treatable cause of hematologic abnormalities. We present and describe two interesting cases in this report. The first case was a 37-year-old man with history of short bowel syndrome and long-term total parenteral nutrition (TPN) presenting with pancytopenia and chronic symmetrical polyarthritis that resembled rheumatoid arthritis. The second case was a 64-year-old man with malabsorption from Cronkhite-Canada Syndrome (CCS) and history of subtotal gastrectomy presenting with macrocytic anemia and neutropenia. Bone marrow examination in both cases revealed cytoplasmic vacuolization of myeloid and erythroid precursors. After copper supplementation was initiated, hematological abnormalities and arthritis were significantly improved. We encourage clinicians to recognize early and identify copper deficiency in patients who have unexplained cytopenia, especially if there is history of upper gastrointestinal tract surgery, malabsorption, or long-term TPN.

Keywords: Anemia, Copper deficiency, Malabsorption, Neutropenia, Pancytopenia, Total parenteral nutrition

Close  
Response

Responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on the jmatonline.com. Although a selection of responses will be included online and in print as readers' letters, their first appearance online means that they are published articles.

Download: PDF