Pancytopenia Complicated with Peripheral Neuropathy Due to Copper Deficiency: Clinical Diagnostic Review

Osamu Imataki; Hiroaki Ohnishi; Akira Kitanaka; Yoshitsugu Kubota; Toshihiko Ishida; Terukazu Tanaka

doi:10.2169/internalmedicine.47.1323

CASE REPORTS

Pancytopenia Complicated with Peripheral Neuropathy Due to Copper Deficiency: Clinical Diagnostic Review

Osamu Imataki, Hiroaki Ohnishi, Akira Kitanaka, Yoshitsugu Kubota, Toshihiko Ishida, Terukazu Tanaka

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Keywords: pancytopenia, copper deficiency, total parenteral nutrition, peripheral neuropathy

JOURNAL OPEN ACCESS

2008 Volume 47 Issue 23 Pages 2063-2065

DOI https://doi.org/10.2169/internalmedicine.47.1323

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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.

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