SHM Converge Scientific Abstract ePoster Gallery-A Case of Pancytopenia Secondary to Copper Deficiency

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Copper deficiency is an important but often overlooked cause of pancytopenia and neurologic symptoms. This case describes a 55-year-old man with chronic alcohol use and Crohn’s disease status post right hemicolectomy who presented with altered mental status, weakness, weight loss, and chronic diarrhea. On admission, he was found to have severe pancytopenia with macrocytic anemia, leukopenia, and thrombocytopenia.<br /><br />Initial evaluation suggested vitamin B12 deficiency and iron deficiency, likely related to alcohol use, so he was treated with vitamin B12, iron, and later zinc. Although his neurologic symptoms improved, his blood counts remained markedly abnormal and he required packed red blood cell transfusions. Further workup revealed copper deficiency, likely due to malabsorption from Crohn’s disease and poor oral intake.<br /><br />After starting intravenous copper replacement, his pancytopenia began to improve. He was discharged on weekly vitamin B12 injections and daily oral copper supplementation.<br /><br />This case highlights that copper deficiency can cause anemia, neutropenia, thrombocytopenia, marrow dysplasia, and neurologic findings such as weakness, numbness, paresthesias, and absent reflexes. It is especially important to consider in patients with gastrointestinal surgery, inflammatory bowel disease, malabsorption, or treatment-resistant cytopenias that do not respond to iron or B12 therapy. Copper deficiency can mimic vitamin B12 deficiency or myelodysplastic syndrome, making diagnosis challenging. Fortunately, it is readily treatable, and hematologic recovery usually occurs within two months of copper replacement.

Asset Subtitle

Christina T. Bui

Meta Tag

Author List Christina T. Bui, Parth Kumar, Smita Kalra

Category Clinical Vignettes

Concept Copper Deficiency

Concept Pancytopenia

Concept Copper Replacement Therapy

Concept Anemia

Concept Neutropenia

Distinguished Non-Finalist

Presenter Organization University of California, Irvine

Presenting Author Christina T. Bui

Track Adult

Keywords

copper deficiency

pancytopenia

macrocytic anemia

neurologic symptoms

Crohn's disease

malabsorption

vitamin B12 deficiency

iron deficiency

zinc supplementation

intravenous copper replacement

Copper Deficiency

Pancytopenia

Copper Replacement Therapy

Anemia

Neutropenia