Clinical Features of Hematological Disorders Caused by Copper Deficiency during Long-Term Enteral Nutrition
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概要
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Objective Copper deficiency has been reported to cause hematological disorders. However, its clinical and hematological characteristics are not fully understood. Therefore, we investigated bedridden patients suffering from copper deficiency and tried to clarify the clinical features of hematological disorders caused by this condition.Patients and Methods Five patients with typical copper deficiency who had been dependent upon enteral nutrition for a long period of time due to various diseases were investigated. We measured hematological parameters and observed the response to copper supplementation therapy and the recovery process of hematological disorders.Results Their mean age was 82.6±10.4 years and the mean duration of enteral nutrition was 16.4±5.2 months. Their serum copper concentration was extremely decreased (range, 3 to 8 μg/dl). All five patients had anemia and neutropenia. On the other hand, platelet count remained within the normal range. After copper supplementation therapy, hemoglobin concentration increased from 6.8±0.7 g/dl to 9.9±0.7 g/dl within a few months (p<0.01). Neutrophil count also increased from 750±370/μl to 3,690±1,210/μl in a few weeks (p<0.01). Mean corpuscular volume (MCV) decreased from 94.3±7.3 fl to 86.0±4.8 fl (p<0.05). Elevated serum ferritin and erythropoietin (EPO) levels were normalized after the improvement of anemia.Conclusion Bicytopenia (anemia and neutropenia) with normal platelet count is a feature of hematological disorders caused by copper deficiency. MCV tends to indicate macrocytic anemia. Serum ferritin and EPO levels are elevated. These hematological abnormalities are improved within a few months after copper supplementation therapy.
- 社団法人 日本内科学会の論文
- 2005-06-01
著者
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Tsuchida Takaya
Department of 1st internal medicine, Nippon Medical School
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TOYODA Takashi
Department of Electrical Engineering, Kyoto University
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Toyoda Takashi
Department Of Electrical Engineering Kyoto University
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Kitamura Akira
Department Of Molecular Cell Dynamics Faculty Of Advanced Life Science Hokkaido University
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TANABE Hiroko
Department of Internal Medicine, Division of Cardiology, Nippon Medical School
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Kitamura Akira
Department Of Anesthesia Nippon Medical School
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Nagano Tomoo
Department Of Internal Medicine Kamisu Saiseikai Hospital
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Nagano Tomoo
Department Of First Internal Medicine Nippon Medical School
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Tanabe Hiroko
Department Of Anesthesia Kyoto University Hospital
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Tanabe Hiroko
Department Of Internal Medicine Kamisu Saiseikai Hospital
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NAGATO Takamichi
Department of Internal Medicine, Kamisu Saiseikai Hospital
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KASAI Gengo
Department of Internal Medicine, Kamisu Saiseikai Hospital
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Kasai Gengo
Department Of Internal Medicine Kamisu Saiseikai Hospital
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Nagato Takamichi
Department Of Internal Medicine Kamisu Saiseikai Hospital
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Tsuchida Takaya
Department Of Internal Medicine Kamisu Saiseikai Hospital
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Toyoda Takashi
Department Of Internal Medicine Kamisu Saiseikai Hospital
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TOYODA Takashi
Department of Applied Physics and Chemistry, The University of Electro-Communications
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