Presentation
Case description: We hereby present the case of a 34-year-old female with gastric bypass surgery who presented with neutropenic fever, abdominal pain and diarrhoea, later found to have extended-spectrum beta-lactamase resistant Escherichia coli urinary [ejcrim.com]
Case Presentation: A 74 year old female presented with a 6 month history of worsening gait ataxia, paresthesias of extremities and progressive spastic paraparesis. She had undergone gastrojejunostomy 6 years ago for complicated peptic ulcer disease. [journals.lww.com]
After 4 weeks, 93% presented normal Cu, 7% presented hypocupremia, low albumin was present in 34%, and low transferrin in 52%. [scielo.isciii.es]
In particular, CSF oligoclonal bands (OCBs) are present in the majority of MS patients and can be suggestive of an MS diagnosis. However, OCBs are not specific to MS and may occur in other CNS inflammatory disorders. [n.neurology.org]
Abstract Clinical similarities between vitamin B(12) and copper deficiencies prompted us to investigate if hypocupremia is present in patients receiving vitamin B(12) supplementation. [ncbi.nlm.nih.gov]
Entire Body System
- Anemia
[…] easily corrected by copper supplementation. ...read moreread less Abstract: Hypocupremia occurred in an adult with sickle cell anemia who received zinc as an antisickling agent for two years. [typeset.io]
TY - JOUR T1 - Copper deficiency in infants; a syndrome characterized by hypocupremia, iron deficiency anemia, and hypoproteinemia. [wwww.unboundmedicine.com]
Hypocupremia occurred in an adult with sickle cell anemia who received zinc as an antisickling agent for two years. The hypocupremia was associated with microcytosis and relative neutropenia. [ncbi.nlm.nih.gov]
This patient's history opened her to many possible causes for anemia and neutropenia. [onlinelibrary.wiley.com]
Correction of anemia and neutropenia in all patients indicates that copper deficiency was the underlying cause ( Table 2 ). [doi.org]
- Epilepsy
Subjects with ATP7A mutations that retain some function seem particularly well protected by early intervention against the possibility of epilepsy. [doi.org]
© 2010 British Epilepsy Association. Cite Benbir, G., Gunduz, A., Ertan, S., & Ozkara, C. (2010). Partial status epilepticus induced by hypocupremia in a patient with Wilson’s disease. [mendeley.com]
The term epilepsy is used to describe chronic, recurrent seizures. Anemia Decreased hemoglobin, Anaemia A reduction in erythrocytes volume or hemoglobin concentration. [rarediseases.oscar.ncsu.edu]
Wilson's disease and epilepsy. Brain. 1988; 111: 1139-1155 Gibbs K. Walshe J.M. Penicillamine and pyridoxine requirements in man. The Lancet. 1966; 1: 175-179 Peters R.A. Shorthouse M. Walshe J.M. [seizure-journal.com]
- Difficulty Walking
Common signs and symptoms of copper deficiency include fatigue and weakness, frequent sickness, weak and brittle bones, problems with memory and learning, difficulties walking, increased cold sensitivity, pale skin, premature gray hair and vision loss [healthline.com]
Patients typically present difficulty walking (gait difficulty) caused by sensory ataxia (irregular muscle coordination) due to dorsal column dysfunction[7] or degeneration of the spinal cord (myelopathy).[3][10] Patients with ataxic gait have problems [en.wikipedia.org]
- Asymptomatic
For patients with severe deficiency requiring IV supplementation, 2‐4 mg for 6 days or until asymptomatic is recommended.7 Patients with severe deficiency should be aware that despite adequate therapy, hematologic abnormalities may persist 2 months following [onlinelibrary.wiley.com]
- Prevention of Wilson's disease in asymptomatic patients. N. Engl. J. Med. 278:352, 1968. [ Links ] 16. STERNLIEB, I. & SCHEINBERG, I.H. - The role of radiocopper in the diagnosis of Wilson's disease. Gastroenterology 77:138, 1979. [ Links ] 17. [scielo.br]
Respiratoric
- Common Cold
Zinc toxicity[edit] Increased consumption of zinc is another cause of copper deficiency.[7] Zinc is often used for the prevention or treatment of common colds and sinusitis (inflammation of sinuses due to an infection), ulcers, sickle cell disease, celiac [en.wikipedia.org]
Gastrointestinal
- Failure to Thrive
Signs and symptoms : Signs and symptoms include failure to thrive, pallor, anemia, muscular hypotonia, short stature, repeated seizures, acne, deep philtrum, wide nasal bridge and early balding. [xpertdox.com]
Failure to thrive Weight faltering, Postnatal failure to thrive, Undergrowth, Poor weight gain [more] Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm. [rarediseases.oscar.ncsu.edu]
Homepage Rare diseases Search Search for a rare disease Disease definition Familial benign copper deficiency is a rare disorder of mineral absorption and transport characterized by hypocupremia that manifests as failure to thrive, mild anemia, repeated [orpha.net]
Differential Diagnoses Bone Marrow Failure Diamond Blackfan anemia Fanconi Anemia Kearns-Sayre Syndrome MELAS Syndrome Myelodysplastic Syndrome Neutropenia Nutritional Considerations in Failure to Thrive Shwachman-Diamond Syndrome Author Zora R Rogers [emedicine.staging.medscape.com]
- Abdominal Pain
Case description: We hereby present the case of a 34-year-old female with gastric bypass surgery who presented with neutropenic fever, abdominal pain and diarrhoea, later found to have extended-spectrum beta-lactamase resistant Escherichia coli urinary [ejcrim.com]
Symptoms of Hypocupremia caused by excessive zinc in denture creams may include: abdominal pain nausea vomiting diarrhea lethargy anemia dizziness Unfortunately, many of the more than 35 million Americans who wear dentures are unaware of the link between [consumerinjurylawyers.com]
She also had nonspecific abdominal pain, constipation, nausea, arthralgias, back pain, myalgias, neck stiffness, weakness, and lightheadedness. [onlinelibrary.wiley.com]
Case presentation A 12-year-old girl was first noted to have elevated alanine aminotransferase (379 U/L, normal: 0–40 U/L) and aspartate aminotransferase (218 U/L, normal, 0–40 U/L) when abdominal pain occurred at the age of 6 years. [bmcgastroenterol.biomedcentral.com]
Musculoskeletal
- Muscle Weakness
Hypocupremia Symptoms Sufferers of denture cream hypocupremia may note a variety of symptoms, including but not limited to: Muscle weakness Labored breathing Skin lesions Others have experienced mild depression, irritability, seizures, and a loss of cognitive [onlinelawyersource.com]
weakness, and ataxia.[2] The neurodegenerative syndrome of copper deficiency has been recognized for some time in ruminant animals, in which it is commonly known as "swayback".[3] Copper deficiency can manifest in parallel with vitamin B12 and other [wikiwand.com]
(infants), arrhythmias Potassium Weakness, anorexia, nausea, irrational behavior, arrhythmias Hyperkalemia cardiac toxicity Sodium Hypovolemia, muscle weakness Edema, hypertension Chloride Infants: hypochloremic metabolic acidosis Hypertension Magnesium [emedicinehealth.com]
weakness, reduced body hair, and altered fat distribution (abdominal obesity) are seen in men with low testosterone, but also in those with a number of other medical conditions. [mdedge.com]
Neurologic manifestations of copper deficiency include myeloneuropathy changes that present as an unsteady gait, distal muscle weakness, or sensory deficits in the extremities. [speciality.medicaldialogues.in]
Neurologic
- Myelopathy
In all 4 patients copper deficiency was identified as the cause of the myelopathy. In 2 patients the copper deficiency occurred after gastric surgery. [ncbi.nlm.nih.gov]
Kumar N (2006) Copper deficiency myelopathy (Human swayback). Mayo Clin Proc 81(10):1371–1384 CrossRef PubMed Google Scholar 3. Kumar N, Ahlskog JE, Klein CJ, Port JD (2006) Imaging features of copper deficiency myelopathy: a study of 25 cases. [doi.org]
- Seizure
Abstract Although seizures are rarely encountered in Wilson's disease (WD), seizures related to hypocupremia have not been reported before. [seizure-journal.com]
Our findings suggest that early diagnosis and treatment improve brain electrical activity and decrease seizure occurrence in classical Menkes disease irrespective of the precise molecular defect. [doi.org]
Signs and symptoms : Signs and symptoms include failure to thrive, pallor, anemia, muscular hypotonia, short stature, repeated seizures, acne, deep philtrum, wide nasal bridge and early balding. [xpertdox.com]
- Neurologic Manifestation
Six of these 8 patients also had neurologic manifestations. Colonic mucosa copper content was increased in the 2 patients with hypocupremia without prior gastric surgery. [ncbi.nlm.nih.gov]
In this issue of Psychiatric Clinics, some of the topics related to neurotoxicity outcomes are: Review of Cognitive Assessment in Neurotoxicology; Neurologic Manifestations of Chronic Methamphetamine Abuse; Emerging Toxic Neuropathies and Myopathies; [books.google.com]
Anemia and neutropenia are well known hematological manifestations of acquired copper deficiency. Less recognized and reported are neurological manifestations which closely mimic the sub acute combined degeneration of vitamin B12 deficiency. [journals.lww.com]
In conclusion, in acquired copper-deficiency-associated myelopathy, correction of blood and MRI alterations precedes that of neurological manifestations, which may remain suboptimal. [doi.org]
Neurologic manifestations of copper deficiency include myeloneuropathy changes that present as an unsteady gait, distal muscle weakness, or sensory deficits in the extremities. [speciality.medicaldialogues.in]
- Dizziness
Anemia, or low levels of red blood cells, will cause fatigue and dizziness. Anemia can also lead to Osteoporosis when bone marrow is over-taxed trying to compensate for the anemia. [onlinelawyersource.com]
Symptoms may vary from mild and vague (e.g., fatigue, dizziness, nausea, shortness of breath) to more pronounced and serious (e.g., ataxia with severe gait disturbance, mental deterioration, respiratory arrest). [aafp.org]
Symptoms of Hypocupremia caused by excessive zinc in denture creams may include: abdominal pain nausea vomiting diarrhea lethargy anemia dizziness Unfortunately, many of the more than 35 million Americans who wear dentures are unaware of the link between [consumerinjurylawyers.com]
Large amounts of Zinc provoke gastrointestinal problems, hair loss, anemia, cramps, kidney problems, dizziness and nausea. Excessive intake of Vitamin C may cause diarrhea, vomiting and abdominal cramps. [ic.steadyhealth.com]
- Headache
In men the symptoms are: Breast enlargement Muscle loss Decreased interest in sex (low libido) If a pituitary or other brain tumor is present (central hypogonadism), there may be: Headaches or vision loss Milky breast discharge (from a prolactinoma) Symptoms [medlineplus.gov]
[…] nausea, vomiting, constipation, polydipsia, polyuria, renal stones, hypertension Vitamin E Loss of reflexes, gait disturbance (posterior tract-spinocerebellar symptoms), paresis of gaze, eczema, psoriasis, poor wound healing, broken capillaries Fatigue, headache [emedicinehealth.com]
If the cause is a brain tumor, symptoms may include headaches or vision loss and a milky discharge from the breasts. The two types of hypogonadism are called primary and central. [chop.edu]
She denied nausea, vomiting, headache, dizziness, myalgia, arthralgia, rash, bleeding, or clotting. The patient was a former smoker and did not drink alcohol. [tandfonline.com]
Adverse effects associated with therapy include headache, hot flushes, insomnia, increased blood pressure, acne, emotional labiality, and nervousness. [ncbi.nlm.nih.gov]
Workup
Extensive workup is necessary to confirm the diagnosis. As for management, the earlier the intervention is initiated, the better prognosis would be for recovery. [ncbi.nlm.nih.gov]
[…] growth and maturation Testicular tissue testing: If the testes are not palpable and if it is not certain whether any testicular tissue is present, administering human chorionic gonadotropin (hCG) and measuring testosterone response may be helpful See Workup [emedicine.medscape.com]
Initial workup included normal serum vitamin B12 Bone marrow biopsy was suggestive of copper deficiency. Serum copper levels were later confirmed to be undetectable. [read.qxmd.com]
When pancytopenia presents in primary care setting in an apparently healthy individual without obvious concerns for malignancy/chemotherapy toxicity, sepsis or disseminated intravascular coagulation, basic workup may include complete metabolic panel, [tandfonline.com]
Initial workup included normal serum vitamin B12. Bone marrow biopsy was suggestive of copper deficiency. Serum copper levels were later confirmed to be undetectable. [casereports.bmj.com]
Serum
- Normocytic Anemia
normocytic patient 2 anemia neutropenia normocytic patient 3 anemia neutropenia microcytic patient 4 anemia neutropenia normocytic Hematological abnormalities in patients with copper deficiency erythroids myeloid ring sideroblasts iron granules in plama [bloodjournal.org]
Vitamin B 12 has been associated with cognitive impairment and macrocytic anemia, while hypocupremia is associated with normocytic anemia and, as yet, there are no reports of cognitive impairment. [ahcmedia.com]
His past medical history was significant for gastroesophageal reflux disease, frequent alcohol and tobacco use, and chronic normocytic anemia and leukopenia. [haematologica.org]
The anemia of copper deficiency often is associated with the presence of ringed sideroblasts and occurs in a number of clinical settings, including a microcytic, macrocytic, or normocytic anemia. [ncbi.nlm.nih.gov]
- Microcytic Anemia
Discussion: Copper deficiency is known to present with microcytic anemia. [bloodjournal.org]
Copper deficiency and microcytic anemia resulting from prolonged ingestion of over-the-counter zinc. Am J Gastroenterol 1992; 87 :1054–1055. 7. Simon, SR, Branda, RF, Tindle, BF, Burns, SL. [nature.com]
Systemic findings include anemia and neutropenia. Fatigue may occur due to microcytic anemia as well as peripheral neuropathy. See Menkes kinky hair syndrome for discussion of inherited copper deficiency. [visualdx.com]
Treatment
Copper-replacement treatment for symptomatic Menkes disease: ethical considerations. [seizure-journal.com]
When the treatment is initiated in newborn babies prior to two months of age, the neurological degeneration may be prevented, but delayed treatment is considerably less effective. [doi.org]
He was then started on treatment with penicillamine 750 mg/day and Zinc Sulphate Monohydrate 280mg/day. His mother reported good compliance with the prescribed medication for the past four years. [bioline.org.br]
However an overzealous treatment with zinc over a prolonged period can have its own dangers. [go.gale.com]
Prognosis
[…] retardation hypocupremia hypobetalipoproteinemia Home medical testing related to Mental retardation - hypocupremia - hypobetalipoproteinemia: Concentration -- Home Testing ADHD -- Home Testing Mental Health: Home Testing: Home Emotional Stress Tests Prognosis [checkorphan.org]
Treatment and prognosis Cocoa is often trialled initially as it contains copper naturally in reasonable amounts and is palatable to the patient 1. [radiopaedia.org]
As for management, the earlier the intervention is initiated, the better prognosis would be for recovery. There are several treatment options which should be tailored to every patient with neurologic Wilson disease. [ncbi.nlm.nih.gov]
Because early diagnosis and treatment seem to result in a better prognosis, the disorder is ideally detected before age 2 weeks. However, diagnostic accuracy of these tests is limited. Thus, other tests are being developed. [msdmanuals.com]
Etiology
While the actual prevalence of copper deficiency is not known, our series of patients and those reported recently by others suggests that it may be an under-recognized etiology of anemia and neutropenia appearing as MDS. [doi.org]
It is increasingly evident that a multitude of etiologies can give rise to signal abnormality in the dorsal and lateral columns of the spinal cord, apart from pernicious anemia. [ncbi.nlm.nih.gov]
Etiology Hypogonadism is a clinical syndrome associated with impaired functional activity of the gonads. [amboss.com]
[…] typical presentation of copper deficiency mimics the more common vitamin B 12 deficiency, which will usually need to be excluded first. blood dyscrasias e.g. anemia, leukopenia, thrombocytopenia neurotoxicity e.g. neuropathy, myelopathy, visual impairment Etiology [radiopaedia.org]
[…] type Article Language English Keyword (fr) HYPOCUPREMIE ETIOLOGIE ANEMIE HEMATIE FALCIFORME ACCIDENT MEDICAMENTEUX VOIE ORALE ZINC HOMME CHIMIOTHERAPIE HEMOPATHIE METABOLISME PATHOLOGIE ELEMENT MINERAL TRAITEMENT PHARMACOLOGIE Keyword (en) HYPOCUPREMIA ETIOLOGY [pascal-francis.inist.fr]
Epidemiology
Neurologically presenting Wilson's disease: epidemiology, pathophysiology and treatment. CNS Drugs 2005;19:185-92. Back to cited text no. 1 [PUBMED] 2. Prodan CI, Holland NR, Wisdom PJ, Burstein SA, Bottomley SS. [bioline.org.br]
Epidemiology. 2006; 17: 308-314 Lowndes S.A. Harris A.L. The role of copper in tumour angiogenesis. J. Mammary Gland Biol. Neoplasia. 2005; 10: 299-310 Luo J.J. [jns-journal.com]
Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology 140, 1785–1794 (2011). 16. Benchimol, E. I. et al. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm. [nature.com]
Recent clinical evidence suggests that obesity is one of the most important risk factors for secondary hypogonadism in men.2–4 Although the actual prevalence of male obesity-related secondary hypogonadism (MOSH) is still unclear, large-scale epidemiological [touchendocrinology.com]
Pathophysiology
[…] of anosmia Prader-Willi syndrome Gaucher's disease Hypothalamic and/or pituitary lesions due to Neoplasm (e.g. prolactinoma, craniopharyngioma, astrocytoma) Trauma, surgery, irradiation Infection Eating disorders (functional hypothalamic amenorrhea) Pathophysiology [amboss.com]
Different patterns of clinical, neurological examination and electrophysiologic findings between hypocupremia and hypercupremia suggest different underlying pathophysiologies. [jns-journal.com]
Neurologically presenting Wilson's disease: epidemiology, pathophysiology and treatment. CNS Drugs 2005;19:185-92. Back to cited text no. 1 [PUBMED] 2. Prodan CI, Holland NR, Wisdom PJ, Burstein SA, Bottomley SS. [bioline.org.br]
Useful For Suggests clinical disorders or settings where the test may be helpful Diagnosis of: -Wilson disease -Primary biliary cirrhosis -Primary sclerosing cholangitis Clinical Information Discusses physiology, pathophysiology, and general clinical [mayomedicallaboratories.com]
Similarly, low testosterone promotes obesity, decreases REM sleep and deep sleep, thus negatively affecting sleep quality.48 The pathophysiological aspects of MOSH are summarised in Figure 2. [touchendocrinology.com]
Prevention
We illustrate the importance of identifying these patients early to prevent irreversible neurological injury. © 2012 John Wiley & Sons A/S. [ncbi.nlm.nih.gov]
Copper Deficiency | Hypocupremia - Causes, Symptoms, Diagnosis, Treatment, and Prevention. Medindia, viewed Mar 27, 2023, https://www.medindia.net/patientinfo/copper-deficiency.htm. [medindia.net]
An understanding of the relation between WD and hepatocellular carcinoma will provide clues to help prevent hepatocellular carcinoma in patients with WD. [doi.org]
Education and Research, Pondicherry - 6, [email protected] Code Number: ni06037 Untreated Wilson's disease in advanced stage is associated with high neurological morbidity, and effective treatment with chelating agents and zinc salts has shown to prevent [bioline.org.br]
Early diagnosis and treatment can prevent significant neurological morbidity. [tandfonline.com]