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一名72岁女性 Roux-en-Y 胃旁路术后发生铜缺乏性脊髓神经病

Copper Deficiency Myeloneuropathy Following Roux-en-Y Gastric Bypass in a 72-Year-Old Female.

作者信息

Kirkland Zachary, Villasmil Ricardo J, Alookaran Jeffrey, Ward Mindy C, Stone David

机构信息

Internal Medicine, Sarasota Memorial Hospital, Sarasota, USA.

Neurology, Sarasota Memorial Hospital, Sarasota, USA.

出版信息

Cureus. 2022 May 18;14(5):e25109. doi: 10.7759/cureus.25109. eCollection 2022 May.

Abstract

Following the implementation of gastric bypass for weight management, copper deficiency has become an increasingly recognized cause of myeloneuropathy. This condition typically presents with primarily sensory deficits leading to ataxia, similar to subacute combined degeneration from Vitamin B12 deficiency. We describe the case of a 72-year-old female patient who initially presented for insidious loss of sensation in her hands and feet, along with intermittent urinary retention. MRI findings included T2 hyperintensities of the dorsal cervicothoracic spinal cord. After identification of low serum copper, intravenous supplementation was started, with immediate improvement in symptoms by the time of discharge. Clinicians should recognize copper deficiency as a potential cause of progressive sensory neuropathy, particularly in patients with a history of gastric bypass.

摘要

在实施胃旁路手术以控制体重后,铜缺乏已成为一种越来越被认可的脊髓神经病病因。这种情况通常主要表现为感觉缺陷,导致共济失调,类似于维生素B12缺乏引起的亚急性联合变性。我们描述了一名72岁女性患者的病例,她最初因手脚隐匿性感觉丧失以及间歇性尿潴留前来就诊。MRI检查结果显示颈胸段脊髓背侧T2高信号。在发现血清铜水平低后,开始静脉补充铜,出院时症状立即得到改善。临床医生应认识到铜缺乏是进行性感觉神经病的潜在病因,尤其是在有胃旁路手术史的患者中。

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