Hematological manifestations of copper deficiency: A retrospective review

Thorvardur R. Halfdanarson, Neeraj Kumar, Chin Yang Li, Robert L. Phyliky, William Hogan

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

Copper deficiency is an established cause of hematological abnormalities but is frequently misdiagnosed. Copper deficiency can present as a combination of hematological and neurological abnormalities and it may masquerade as a myelodysplastic syndrome. We reviewed the records of patients with hypocupremia and hematologic abnormalities identified between 1970 and 2005. Patients with hypocupremia unrelated to copper deficiency (e.g. Wilson's disease) were excluded. Forty patients with copper deficiency and hematological abnormalities were identified. Ten patients (25%) had undergone bariatric (weight reduction) surgery and an additional 14 patients (35%) had undergone surgery on the gastrointestinal tract, most commonly gastric resection. In 12 cases, no cause for copper deficiency was identified. Anemia and neutropenia were the most common hematologic abnormalities identified and the majority of the patients also had neurologic findings, most commonly due to myeloneuropathy. Abnormalities observed on bone marrow examination including vacuoles in myeloid precursors, iron-containing plasma cells, a decrease in granulocyte precursors and ring sideroblasts may be valuable clues to the diagnosis. Copper deficiency is an uncommon but very treatable cause of hematologic abnormalities.

Original languageEnglish (US)
Pages (from-to)523-531
Number of pages9
JournalEuropean Journal of Haematology
Volume80
Issue number6
DOIs
StatePublished - Jun 2008

Fingerprint

Copper
Bone Marrow Examination
Bariatrics
Hepatolenticular Degeneration
Myelodysplastic Syndromes
Neurologic Manifestations
Vacuoles
Plasma Cells
Neutropenia
Diagnostic Errors
Granulocytes
Gastrointestinal Tract
Anemia
Weight Loss
Stomach
Iron

Keywords

  • Anemia
  • Copper deficiency
  • Leukopenia
  • Myelopathy
  • Neutropenia
  • Pancytopenia

ASJC Scopus subject areas

  • Hematology

Cite this

Hematological manifestations of copper deficiency : A retrospective review. / Halfdanarson, Thorvardur R.; Kumar, Neeraj; Li, Chin Yang; Phyliky, Robert L.; Hogan, William.

In: European Journal of Haematology, Vol. 80, No. 6, 06.2008, p. 523-531.

Research output: Contribution to journalArticle

Halfdanarson, Thorvardur R. ; Kumar, Neeraj ; Li, Chin Yang ; Phyliky, Robert L. ; Hogan, William. / Hematological manifestations of copper deficiency : A retrospective review. In: European Journal of Haematology. 2008 ; Vol. 80, No. 6. pp. 523-531.
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