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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.

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