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. 2021 Aug 26;2(4):729-737.
doi: 10.1002/jha2.278. eCollection 2021 Nov.

Cytopenia associated with copper deficiency

Kaori Uchino  1   2 , Lam Vu Quang  1 , Megumi Enomoto  3 , Yuta Nakano  1   2 , Saki Yamada  1   2 , Saori Matsumura  1   2 , Jo Kanasugi  1   2 , Soichi Takasugi  1   2 , Ayano Nakamura  1   2 , Tomohiro Horio  1   2 , Satsuki Murakami  1   2 , Mineaki Goto  1   4 , Shohei Mizuno  1   2 , Hidesuke Yamamoto  1   2 , Masaya Watarai  1   5 , Ichiro Hanamura  1   2 , Akiyoshi Takami  1   2
Affiliations

Cytopenia associated with copper deficiency

Kaori Uchino et al. EJHaem. .

Abstract

Introduction: Due to an increased incidence of copper deficiency, we investigated adult patients who had low serum levels of copper with cytopenia at our hospital from March 2014 to March 2021.

Methods: We retrospectively reviewed the clinical data of patients who had been diagnosed with cytopenia due to copper deficiency at the Aichi Medical University Hospital from March 2014 to March 2021.

Results: In the 15 patients with cytopenia secondary to low serum copper level, 11 had cytopenia of two to three lineages; three (27%) had pancytopenia, and eight (73%) had bicytopenia. Of the 15 patients, nine (60%) underwent bone marrow examinations; three (30%) showed typical morphologic features associated with copper deficiency, such as multiple clear cytoplasmic vacuoles in erythroblasts and myeloid cells, and three (30%) showed dysplastic features as observed in myelodysplastic syndrome. Among the 14 (93%) patients who were treated with copper supplements, had cessation of zinc supplements, or both, 11 (73%) and eight (53%) showed normal copper levels and hematological improvement, respectively.

Conclusion: Copper deficiency is more common than expected and should be considered in patients with unexplained cytopenia.

Keywords: copper deficiency; cytopenia; cytoplasmic vacuoles; zinc supplements.

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Conflict of interest statement

The authors declare no conflict of interest in association with the present study.

Figures

FIGURE 1
FIGURE 1
Typical morphologic features associated with copper deficiency: (A) cytoplasmic vacuoles in erythroid precursor, (B) hemosiderin containing plasma cells, and (C) megakaryocyte with the markedly abnormal nucleus
See this image and copyright information in PMC

References

    1. Jin J, Mulesa L, Carrilero Rouillet M. Trace elements in parenteral nutrition: considerations for the prescribing clinician. Nutrients. 2017;9(5):440. - PMC - PubMed
    1. Shils ME. Modern nutrition in health and disease. 9th ed. Baltimore, MD: Williams & Wilkins; 1999. p. 241–52.
    1. Trumbo P, Yates AA, Schlicker S, Poos M. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc. 2001;101(3):294‐301. - PubMed
    1. Gabreyes AA, Abbasi HN, Forbes KP, McQuaker G, Duncan A, Morrison I. Hypocupremia associated cytopenia and myelopathy: a national retrospective review. Eur J Haematol. 2013;90(1):1‐9. - PubMed
    1. Tümer Z, Møller LB. Menkes disease. Eur J Hum Genet. 2010;18(5):511‐8. - PMC - PubMed

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