When metals compete: a case of copper-deficiency myeloneuropathy and anemia

  title={When metals compete: a case of copper-deficiency myeloneuropathy and anemia},
  author={Rebecca I Spain and Thomas P. Leist and Eduardo A. De Sousa},
  journal={Nature Clinical Practice Neurology},
Background A 47-year-old woman with an otherwise unremarkable medical history was referred to the multiple sclerosis clinic by her primary neurologist for evaluation of a 2–3 year history of progressive knee and back pain, weakness, paresthesias, sensory loss, ataxia, and falls. During the same period, she had received blood transfusions for unexplained anemia and leukopenia. She had been wearing dentures for many years.Investigations Physical examination, neurological examinations (assessments… 
[Peripheral neuropathy, myelopathy, cerebellar ataxia, and subclinical optic neuropathy associated with copper deficiency occurring 23 years after total gastrectomy].
We report a 61-year-old man with slowly progressive gait disturbance and paresthesia in the lower extremities following a total gastrectomy for gastric cancer 23 years previously. The patient
Copper deficiency myelopathy probably caused by long-lasting daily excessive intake of zink.
A 39-year-old woman with slowly progressive spastic gait and paresthesia in the lower extremities and extreme unbalanced diet of having 15-20 oysters everyday over 5 years is reported, considered that zinc excess caused copper deficiency myelopathy.
Approach to a case of myeloneuropathy
The pattern of neurologic involvement and results obtained from a battery of biochemical tests often help in establishing the correct diagnosis of myeloneuropathy, a frequently encountered condition and often poses a diagnostic challenge.
The role of the clinical biochemist in detection of zinc-induced copper deficiency
A middle-aged woman with neutropenia and ataxia was found to have raised plasma zinc and profoundly low plasma copper concentrations and after the zinc prescription was stopped, her copper and zinc concentrations and neutropy normalized but she only had partial improvement in neurological status.
Zinc-containing denture adhesive: a potential source of excess zinc resulting in copper deficiency myelopathy
A case of a 58-year-old man diagnosed with copper deficiency myelopathy possibly due to zinc-containing denture cream overuse is presented.
ATP7A-related copper transport diseases—emerging concepts and future trends
  • S. Kaler
  • Biology
    Nature Reviews Neurology
  • 2011
It is indicated that ATP7A has a crucial but previously unappreciated role in motor neuron maintenance, and that the mechanism underlying ATP 7A-related distal motor neuropathy is distinct from Menkes disease and OHS pathophysiology.
Inherited Disorders of Human Copper Metabolism
  • S. Kaler, S. Packman
  • Biology, Medicine
    Emery and Rimoin's Principles and Practice of Medical Genetics and Genomics
  • 2021
A female with progressive four-limb paresthesias and gait difficulty.
A case of progressive four-limb paresthesias and gait difficulty in a female who had previously undergone gastric bypass surgery is discussed.


Copper deficiency myelopathy produces a clinical picture like subacute combined degeneration
Unrecognized copper deficiency appears to be a common cause of idiopathic myelopathy in adults, and early recognition and copper supplementation may prevent neurologic deterioration.
[Pancytopenia, arthralgia and myeloneuropathy due to copper deficiency].
Copper deficiency may be a differential diagnosis for hematologic abnormalities like pancytopenia, even if a disorder of intestinal resorption or a proteinuria occurs, and myeloneuropathy is a rare complication of this deficiency.
Copper deficiency myelopathy (human swayback).
Patients with copper deficiency myelopathy seen at the Mayo Clinic in Rochester, Minn, are described and the literature on neurological manifestations of acquired copper deficiency in humans is reviewed.
Copper deficiency myelopathy induced by repetitive parenteral zinc supplementation during chronic hemodialysis
A 61 year old woman with a 6 month history of progressive gait ataxia, lower limb weakness and numbness of her feet is diagnosed with an iatrogenic copper deficiency myelopathy induced by parenteral zinc overloading during chronic hemodialysis.
Clinicopathological analysis of hematological disorders in tube-fed patients with copper deficiency.
Bicytopenia is likely to occur in tube-fed patients with copper deficiency, and copper deficiency appears to be associated with cytoplasmic vacuolization and electron-dense deposits in mitochondria in erythroid and myeloid cells.
Subacute Combined Degeneration Due to Copper Deficiency
A patient with sensory ataxia and spastic paraplegia from copper deficiency is reported whose MRI demonstrates abnormal signal restricted to the dorsal and lateral columns, providing clear radiological support of an association between hypocupremia and combined system degeneration.
Copper deficiency and sideroblastic anemia associated with zinc ingestion
Self‐administered zinc appears to have caused severe copper deficiency, with secondary anemia and neutropenia, and Physicians should be aware of this deleterious and completely reversible effect of megadose mineral therapy.
Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver, by S. A. Kinnier Wilson, (From the National Hospital, and the Laboratory of the National Hospital, Queen Square, London) Brain 1912: 34; 295-509.
Progressive lenticular degeneration may be defined as a disease which occurs in young people, which is often familial but not congenital or hereditary, and is characterised by involuntary movements, usually of the nature of tremor, dysarthria, dysphagia, muscular weakness, spasticity, and contractures with progressive emaciation.
Neurologic complications of gastric bypass surgery for morbid obesity
A wide spectrum of serious neurologic conditions may follow bariatric surgery, and these complications may occur acutely or decades later.
Kupfermangel als seltene Ursache von Panzytopenie, Arthralgien und Gangstörungen
A 71–year–old woman was hospitalized because of increasing pancytopenia and ataxic gait, that resulted in a near–complete inability to walk without assistance, and a copper deficiency was then identified as the likely underlying cause for the low blood cell counts and neurologic deficits.