Gregg Xylina T, Reddy Vishnu, Prchal Josef T
Baylor College of Medicine, Houston, TX 77030, USA.
Blood. 2002 Aug 15;100(4):1493-5. doi: 10.1182/blood-2002-01-0256.
We describe a woman with severe neutropenia and dependency on red blood cell transfusions who had previously undergone Billroth II surgery and whose bone marrow (BM) showed morphologic characteristics typical of myelodysplastic syndrome (MDS) with ringed sideroblasts. She had transient reversal of anemia and severe neutropenia after therapy with erythropoietin and granulocyte colony-stimulating factor. Because of relapse while receiving growth factors, the patient was referred for allogeneic BM transplantation. A pretransplantation nutritional evaluation revealed severe copper deficiency, and her hematologic abnormalities resolved fully with copper therapy. This case shows that copper deficiency should be an integral part of the differential diagnosis of sideroblastic MDS, even in patients not requiring parenteral nutrition.
我们描述了一名患有严重中性粒细胞减少症且依赖红细胞输血的女性，她之前接受过毕罗Ⅱ式手术，其骨髓显示出具有环形铁粒幼细胞的骨髓增生异常综合征（MDS）的典型形态学特征。在用促红细胞生成素和粒细胞集落刺激因子治疗后，她的贫血和严重中性粒细胞减少症出现了短暂缓解。由于在接受生长因子治疗期间病情复发，该患者被转诊进行异基因骨髓移植。移植前的营养评估显示严重铜缺乏，并且她的血液学异常通过铜治疗完全得到解决。该病例表明，即使在不需要肠外营养的患者中，铜缺乏也应成为铁粒幼细胞性MDS鉴别诊断的一个组成部分。
