Copper deficiency

Copper deficiency also known as hypocupraemia is exceedingly rare in the normal population.

• historically the deficiency was present in patients receiving total parenteral hyperalimentation or total parental nutrition (TPN)
• currently, it is increasingly recognised in patients undergoing gastric resection or bariatric gastric reduction surgery (1)
  • in a case series of 136 patients who underwent gastric bypass surgery, 9.6% had hypocupraemia
  • two other case series containing 64 and 141 bariatric surgery patients respectively reported
    • substantial hypocupraemia in 23% at 6 months and 70% at 3 years
    • a progressive reduction in average serum copper concentrations over five years (2)

Hypocupraemia may lead to:

• vitamin B12 deficiency-like symptoms
• anemia and leukopenia with myelodysplastic manifestations
• growth retardation
• defective keratinization and pigmentation of the hair
• neurodegenerative syndrome
• mental deterioration
• scurvy-like changes in the skeleton (3)

Reference:

• (1) Robinson SD, Cooper B, Leday TV. Copper deficiency (hypocupremia) and pancytopenia late after gastric bypass surgery. Proceedings (Baylor University Medical Center). 2013;26(4):382-386.
• (2) Chhetri SK et al. Copper deficiency. BMJ. 2014;348:g3691
• (3) Bost M et al. Dietary copper and human health: Current evidence and unresolved issues. J Trace Elem Med Biol. 2016;35:107-15