長期高カロリー輸液施行中に発生した銅欠乏症の1例

概要

論文の詳細を見る
Copper deficiency in a 2-year-old boy with total intestinal aganglionosis is reported. Proximal jejunostomy was created just below the Treitz ligament. TPN had been performed for prolonged period of time since birth. As for micronutrients, iron, zinc, iodine and copper were administered in TPN solution. At 1 years and 8 months of age, the amount of copper in TPN was reduced from 26μg/kg/day to 13μg/kg/day. After 2 months, progressive anemia, leukopenia and neutropenia developed. His redcell count was 3,400,000/mm3 despite of frequent blood transfusions. White blood cells fell down to 2600/mm3 with neutropenia (880/mm^3) at 2 years and 2 months of age. The serum copper concentration was 61μg/dl (normal 1 70-150μg/dl). The amount of copper in TPN was added to 54μg/kg/day at 2 years and 4 months of age. Subsequently progressive anemia, leukopenia and neutropenia improved. The radiographic findings of metacarpi showed osteoporosis. The amount of copper excretion in jejunal fluid ranged from 50 to 80μg/day even in the copper deficient period. In this case, copper deficiency might have been partly due to excessive excretion of copper from jejunostomy. Therefore frequent monitoring of serum copper concentration could be necessary, particularly in a case with long standing jejunostomy.
日本小児外科学会の論文
1990-05-20