Amin Adina, Khoury Neil C, Lacayo Miguel, Kostanyan Sofya
Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA.
Cureus. 2022 Feb 28;14(2):e22705. doi: 10.7759/cureus.22705. eCollection 2022 Feb.
Neuropathy may arise from many different etiologies - from diabetes and nerve compression to viral infections and chemotherapy side effects; many patients suffer from neuropathic symptoms. While some etiologies produce irreversible neuropathy, others, such as vitamin and mineral deficiencies, lead to a possibly reversible disease process once treated. General clinicians should strive for early and prompt diagnosis of copper deficiency neuropathy whenever possible, especially in patients with normal vitamin B12 levels who present with a subacute gait disorder or prominent sensory ataxia. We present a case of a 73-year-old female with a surgical history of Roux-en-Y gastric bypass (RYGB) 20 years prior, who presented with difficulty with ambulation due to sensory ataxia and bilateral, ascending, sensory neuropathy, who was diagnosed with acquired copper deficiency-induced myeloneuropathy.
神经病变可能由多种不同病因引起——从糖尿病、神经受压到病毒感染和化疗副作用;许多患者患有神经病变症状。虽然有些病因会导致不可逆的神经病变,但其他病因,如维生素和矿物质缺乏,一旦得到治疗,可能会导致可逆的疾病过程。普通临床医生应尽可能争取早期及时诊断铜缺乏性神经病变,尤其是对于维生素B12水平正常但出现亚急性步态障碍或明显感觉性共济失调的患者。我们报告一例73岁女性病例,该患者20年前有Roux-en-Y胃旁路术(RYGB)手术史,因感觉性共济失调和双侧上行性感觉神经病变而出现行走困难,被诊断为获得性铜缺乏性脊髓神经病。