Isolated neutropenia caused by copper deficiency due to jejunal feeding and excessive zinc intake:A case report  

作　　者：Hiromitsu Ohmori Hiroko Kodama Masahiko Takemoto Masami Yamasaki Tomio Matsumoto Masao Kumode Takafumi Miyachi Ryo Sumimoto 

机构地区：[1]Department of Pediatrics,National Hospital Organization Yanai Medical Center,Yanai 742-1352,Yamaguchi,Japan [2]Doctoral Program in Health and Dietetics,Graduate School of Health Sciences,Teikyo Heisei University,Toshima-ku 170-8445,Tokyo,Japan [3]Department of Surgery,National Hospital Organization Yanai Medical Center,Yanai 742-1352,Yamaguchi,Japan [4]Department of Neurology,National Hospital Organization Yanai Medical Center,Yanai 742-1352,Yamaguchi,Japan [5]Department of Pediatrics,Biwako Gakuen Kusatsu Medical and Welfare Center for Children and Persons with Severe Motor and Intellectual Disabilities,Kusatsu 525-0034,Shiga,Japan

出　　处：《World Journal of Clinical Cases》2021年第29期8825-8830,共6页世界临床病例杂志

摘　　要：BACKGROUND Percutaneous endoscopic gastrostomy with jejunal extension(PEG-J)is often used to treat patients with neurological impairment and difficulty in swallowing.However,these patients often develop copper deficiency.This report describes a case of isolated neutropenia,which is a rare manifestation of copper deficiency.CASE SUMMARY Our patient was a 19-year-old boy with neurological impairment and gastroesophageal reflux.He received PEG-J feeding,including an enteral supplement containing copper and zinc.However,as his serum zinc level was low(53μg/dL)at the age of 19 years and 2 mo,we changed to a zinc-rich supplement containing 22 mg/d of zinc and 1.0 mg/d of copper.The supplement comprised a mixture of isocal 1.0 junior(5 packs/d),Tezon[2 packs(250 mL)/d],and cocoa powder.Seven months later,he had neutropenia(606/mm^(3))with a serum copper level of 16μg/dL.There were no other manifestations of copper deficiency,including anemia.Copper deficiency and neutropenia both improved following the administration of cocoa powder and Tezon.CONCLUSION In patients receiving long-term PEG-J feeds,white blood cell counts,hemoglobin,and serum levels of copper and zinc should be regularly monitored.

关 键 词：Percutaneous endoscopic gastrostomy with jejunal extension feeding NEUTROPENIA Copper ZINC Deficiency Case report 

分 类 号：R591.1[医药卫生—内科学] R557.3[医药卫生—临床医学]