Camblor M, De la Cuerda C, Bretón I, Pérez-Rus G, Alvarez S, García P
Nutrition Section, Hospital General Universitario 'Gregoria Marañón', Madrid, Spain.
Clin Nutr. 1997 Jun;16(3):129-31. doi: 10.1016/s0261-5614(97)80239-7.
Copper deficiency is a rare complication of enteral nutrition. Haematologic abnormalities such as neutropenia and anaemia, but not pancytopenia, have been described associated to copper deficiency. We report the case of a patient requiring long term enteral nutrition through jejunostomy who developed copper deficiency and pancytopenia. In 1991, a 47-year-old woman was admitted with severe gastroesophageal mucositis after an attempted suicide with caustic intake. Enteral nutrition with a commercial, polymeric, fiber-containing formula was started. Twenty-eight months later, the patient developed anemia and neutropenia that did not respond to combined iron and parenteral vitamin B(12) supplementation. In 1996 the patient showed pancytopenia and low serum levels of copper and ceruloplasmin. Pancytopenia improved after copper supplementation. Possible mechanism causing copper deficiency and pancytopenia are discussed. We conclude that assessment of copper status is advisable in patients receiving long-term enteral nutrition by jejunostomy.
铜缺乏是肠内营养罕见的并发症。已有报道称，铜缺乏与诸如中性粒细胞减少和贫血等血液学异常有关，但与全血细胞减少无关。我们报告了一例通过空肠造口术需要长期肠内营养的患者发生铜缺乏和全血细胞减少的病例。1991年，一名47岁女性因摄入腐蚀性物质自杀未遂后出现严重的胃食管黏膜炎而入院。开始使用一种含纤维的商业化聚合配方进行肠内营养。28个月后，患者出现贫血和中性粒细胞减少，补充铁剂和肠外维生素B12联合治疗无效。1996年，患者出现全血细胞减少，血清铜和铜蓝蛋白水平降低。补充铜后全血细胞减少有所改善。本文讨论了导致铜缺乏和全血细胞减少的可能机制。我们得出结论，对于通过空肠造口术接受长期肠内营养的患者，建议评估铜状态。
