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Prepublished online as a Blood First Edition Paper on May 17, 2002; DOI 10.1182/blood-2002-01-0256.

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Blood, 15 August 2002, Vol. 100, No. 4, pp. 1493-1495

BRIEF REPORT

Copper deficiency masquerading as myelodysplastic syndrome

Xylina T. Gregg, Vishnu Reddy, and Josef T. Prchal

From Baylor College of Medicine, Houston, TX; and the Department of Pathology, University of Alabama at Birmingham.

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.

© 2002 by The American Society of Hematology.
 

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