[Copper deficiency anemia morphologically mimicking myelodysplastic syndrome].

Taku Kikuchi, Takehiko Mori, Takayuki Shimizu, Shinya Morita, Hidaka Kono, Ken Nakagawa, Takayuki Mitsuhasi, Mitsuru Murata, Shinichiro Okamoto

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A 64-year-old man underwent kidney transplantation for progressive chronic renal failure which had developed 8 years after allogeneic bone marrow transplantation for acute myeloid leukemia. Because of post-operative complications, he had been placed on intravenous hyperalimentation. Three months after the transplantation, anemia rapidly progressed (hemoglobin, 7.9 g/dl). The proportion of reticulocytes was 0.2%, but white blood cell and platelet counts remained within normal ranges. Serum iron, vitamin B12, and folate levels were normal. Bone marrow examination showed the presence of ringed sideroblasts and cytoplasmic vacuoles in a fraction of erythroid cells. Megakaryocytes were adequate in number with normal morphology. Although the findings were consistent with refractory anemia with ringed sideroblasts according to the WHO classification, cytoplasmic vacuolations were also observed in myeloid cells, suggesting copper deficiency. Indeed, serum copper and ceruloplasmin levels were found to be low (33 μg/dl and 11 mg/dl, respectively), and oral copper supplementation at a daily dose of 1 mg was initiated. There was a prompt increase in reticulocytes, and the hemoglobin level was normalized within one month, in response to this regimen. In progressive anemia cases with ringed sideroblasts in the bone marrow, copper deficiency should be considered in the differential diagnosis.

Original languageEnglish
Pages (from-to)345-349
Number of pages5
Journal[Rinshō ketsueki] The Japanese journal of clinical hematology
Volume55
Issue number3
Publication statusPublished - 2014

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Myelodysplastic Syndromes
Anemia
Copper
Reticulocytes
Hemoglobins
Refractory Anemia
Bone Marrow Examination
Erythroid Cells
Ceruloplasmin
Megakaryocytes
Total Parenteral Nutrition
Homologous Transplantation
Myeloid Cells
Vitamin B 12
Vacuoles
Serum
Bone Marrow Transplantation
Platelet Count
Leukocyte Count
Folic Acid

ASJC Scopus subject areas

  • Medicine(all)

Cite this

[Copper deficiency anemia morphologically mimicking myelodysplastic syndrome]. / Kikuchi, Taku; Mori, Takehiko; Shimizu, Takayuki; Morita, Shinya; Kono, Hidaka; Nakagawa, Ken; Mitsuhasi, Takayuki; Murata, Mitsuru; Okamoto, Shinichiro.

In: [Rinshō ketsueki] The Japanese journal of clinical hematology, Vol. 55, No. 3, 2014, p. 345-349.

Research output: Contribution to journalArticle

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AU - Mitsuhasi, Takayuki

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AU - Okamoto, Shinichiro

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