Presentation
We present a 45-year-old man with copper deficiency (hypocupremia)-associated myelopathy. Acquired copper deficiency is a recently recognized cause of myelopathy in adults. [ncbi.nlm.nih.gov]
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]
Case #3 A 53-year-old man presented with anemia, leukopenia and neurological symptoms (Table 1). [haematologica.org]
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]
Entire Body System
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Anemia
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]
TY - JOUR T1 - Copper deficiency in infants; a syndrome characterized by hypocupremia, iron deficiency anemia, and hypoproteinemia. [wwww.unboundmedicine.com]
Her past medical history included pernicious anemia, pancreatitis, and a cholecystectomy; there was no history of alcohol abuse. The patient had been treated for pernicious anemia without response. [haematologica.org]
The book mentions need for interventional strategies for the management of nutritional anemia. [books.google.com]
We have since observed hypoceruloplasminemia of varying degrees in several other sickle cell anemia patients who were receiving oral zinc therapy. This complication was easily corrected by copper supplementation. [210.46.82.192]
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Metal Worker
Inhalation of freshly oxidized zinc or zinc oxide fumes, as by metal workers, causes metal fume fever (q.v.). [medicine_en_ru.academic.ru]
Gastrointestinal
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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]
[…] to thrive, mild anemia, repeated seizures, hypotonia, and seborrheic skin. [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]
Neurologic
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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]
Adverse effects associated with therapy include headache, hot flushes, insomnia, increased blood pressure, acne, emotional labiality, and nervousness. [ncbi.nlm.nih.gov]
Copper toxicity can have unpleasant and potentially fatal side effects, including (40, 41): Nausea Vomiting (food or blood) Diarrhea Stomach pain Black, “tarry” stools Headaches Difficulty breathing An irregular heartbeat Low blood pressure Coma Yellow [healthline.com]
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]
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]
The patient was not on any psychotropic medications that predispose to aplastic anemia, but her prior psychiatric history and suicide attempt would prompt a workup for toxic ingestions. [onlinelibrary.wiley.com]
[…] 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]
Microbiology
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Gram-Positive Bacteria
The in vitro copper uptake was compared between this isolated pathogenic strain and two non-pathogenic control strains of gram positive bacteria Bacillus thuringiensis strain Israelis as well as gram negative bacteria Enterobacter aerogenes. [read.qxmd.com]
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Pseudomonas
November 2009: Neurotoxicology #34 COMPARATIVE STUDY Muayad M Abboud, Humodi A Saeed, Khaled A Tarawneh, Khaled M Khleifat, Amjad Al Tarawneh Pseudomonas aeruginosa was isolated from infected burn patients and characterized by standard biochemical tests [read.qxmd.com]
Treatment
Copper-replacement treatment for symptomatic Menkes disease: ethical considerations. [seizure-journal.com]
The early recognition and treatment of the symptoms of hypocupremia is emphasized to avoid these long-term sequelae. [ncbi.nlm.nih.gov]
[…] an overzealous treatment with zinc over a prolonged period can have its own dangers. [go.gale.com]
Article Access Statistics Viewed 5321 Printed 133 Emailed 2 PDF Downloaded 190 Comments However an overzealous treatment with zinc over a prolonged period can have its own dangers. [neurologyindia.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]
[…] copper and iron levels and nephrotic syndrome.Methods:Serum zinc,copper,iron were determined by atomic absorption spectrometry in 50 patients with nephrotic syndrome,and the relationship between zinc,copper and iron deficiency and disease progression and prognosis [chinaqking.com]
Etiology
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]
[…] 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]
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]
Copper deficiency in sheep inWestern Australia: a preliminary account of the etiology of enzootic ataxia in lambs and an anemia in ewes. Aust Vet J. 1937 ; 13 : 138 – 49. 6. Barlow, RM. [cambridge.org]
Epidemiology
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
Different patterns of clinical, neurological examination and electrophysiologic findings between hypocupremia and hypercupremia suggest different underlying pathophysiologies. [jns-journal.com]
[…] 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]
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]
This paper reviews the physiology and pathophysiology of disorders occurring during the postnatal activation of the gonadal axis. 34. Bergadá, I. et al. [nature.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]
Prevention - Mental retardation hypocupremia hypobetalipoproteinemia Not supplied. [checkorphan.org]
Kaveer 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 the development of or reverse neurological symptoms.[1] However [go.gale.com]
Read, AP, and Fielding, DW, Apparent prevention of neural tube defects by periconceptional vitamin supplementation, Arch. [books.google.com]
We illustrate the importance of identifying these patients early to prevent irreversible neurological injury. Biography : Alemayehu A. [longdom.org]