The Japanese Journal of Clinical Dialysis Vol.20 No.9(9)

Theme Trace Elements in Dialysis Treatment
Title Anemia caused by copper deficiencies
Publish Date 2004/08
Author Hiroaki Miyajima First Department of Medicine, Hamamatsu University School of Medicine
[ Summary ] Copper (Cu) deficiency is a rare condition, but with unusual types of nutrition, such as total parenteral nutrition (TPN), anemia and neutropenia due to copper deficiency may occur. A forty-four-year-old woman who had previously undergone intestinal resection and received TPN over a long period developed anemia and neutropenia. Vacuoles were observed in some erythroblasts and immature myeloid cells, and mature granulocytes levels were reduced in the bone marrow. Both serum copper and ceruloplasmin were very low. Intravenous administration of copper sulfate resulted in improvement in anemia and neutropenia within two weeks. The exact cause of the anemia and neutropenia with copper deficiency is unclear, but it is suggested that the decreased activity of enzymes containing copper (ceruloplasmin, cytochrome c oxidase, and superoxide dismutase) may be related to a disturbance in iron metabolism, a decrease in the rate of cellular maturation in the bone marrow, and the shorted life span of erythrocytes and granulocytes.
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