The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Anemia and Neutropenia Caused by Copper Deficiency

[+] Article and Author Information

▸Requests for reprints should be addressed to William M. Dunlap, M.D., 1906 Stone St., Raleigh, NC 27608.

*Deceased 19 May 1973.▸From the Departments of Medicine and Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia.

Richmond, Virginia

Ann Intern Med. 1974;80(4):470-476. doi:10.7326/0003-4819-80-4-470
Text Size: A A A

Two patients with copper deficiency had extensive bowel surgery and received long-term parenteral hyperalimentation. One was neutropenic and anemic, with dimorphous erythrocytes. Marrow examination showed a predominance of early granulocytes and cytoplasmic vacuolization of erythroid and myeloid elements. Erythroid development was megaloblastoid and diminished, with increased sideroblasts. These abnormalities disappeared after oral copper therapy, reappeared when therapy was withdrawn, and again disappeared with intravenous copper therapy. The other patient, not as severely hypocupremic, was neutropenic but not anemic. Her marrow showed normoblastic erythropoiesis with cytoplasmic vacuolization of erythroid and myeloid precursors and a predominance of early granulocytes. The neutropenia was corrected with oral copper. Possible mechanisms causing the anemia and neutropenia are discussed. The duodenum seems to be a site of copper absorption. Copper supplementation is needed for patients receiving long-term parenteral hyperalimentation.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.