51
|
Abstract
Many processes lead to anemia. This review covers anemias that are less commonly encountered in the United States. These anemias include hemoglobin defects like thalassemia, bone marrow failure syndromes like aplastic anemia and pure red cell aplasia, and hemolytic processes such as paroxysmal nocturnal hemoglobinuria. The pathogenesis, diagnostic workup, and treatment of these rare anemias are reviewed.
Collapse
Affiliation(s)
- Molly Maddock Daughety
- Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97201-3098, USA
| | - Thomas G DeLoughery
- Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97201-3098, USA; Division of Hematology/Medical Oncology, Department of Medicine, Knight Cancer Institute, Oregon Health and Science University, MC L586, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.
| |
Collapse
|
52
|
Copper therapy reduces intravascular hemolysis and derepresses ferroportin in mice with mosaic mutation (Atp7a mo-ms): An implication for copper-mediated regulation of the Slc40a1 gene expression. Biochim Biophys Acta Mol Basis Dis 2017; 1863:1410-1421. [PMID: 28219768 DOI: 10.1016/j.bbadis.2017.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 02/06/2023]
Abstract
Mosaic mutant mice displaying functional dysfunction of Atp7a copper transporter (the Menkes ATPase) are an established animal model of Menkes disease and constitute a convenient tool for investigating connections between copper and iron metabolisms. This model allows to explore changes in iron metabolism in suckling mutant mice suffering from systemic copper deficiency as well as in young and adult ones undergone copper therapy, which reduces lethal effect of the Atp7a gene mutation. Our recent study demonstrated that 14-day-old mosaic mutant males display blood cell abnormalities associated with intravascular hemolysis, and show disturbances in the functioning of the hepcidin-ferroportin regulatory axis, which controls systemic iron homeostasis. We thus aimed to check whether copper supplementation recovers mutants from hemolytic insult and rebalance systemic iron regulation. Copper supplementation of 14-day-old mosaic mutants resulted in the reestablishment of hematological status, attenuation of hepicidin and concomitant induction of the iron exporter ferroportin/Slc40a1 expression in the liver, down-regulated in untreated mutants. Interestingly, treatment of wild-type males with copper, induced hepcidin-independent up-regulation of ferroportin protein level in hepatic macrophages in both young and adult (6-month-old) animals. Stimulatory effect of copper on ferroportin mRNA and protein levels was confirmed in bone marrow-derived macrophages isolated from both wild-type and mosaic mutant males. Our study indicates that copper is an important player in the regulation of the Slc40a1 gene expression.
Collapse
|
53
|
Oo TH, Hu S. Copper deficiency-related bone marrow changes secondary to long-term total parenteral nutrition. Clin Case Rep 2016; 5:195-196. [PMID: 28174650 PMCID: PMC5290493 DOI: 10.1002/ccr3.789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/23/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022] Open
Abstract
Total parenteral nutrition can be complicated by the marrow sea‐blue histiocytes as well as copper deficiency‐related bone marrow changes. Cytoplasmic vacuoles in the erythroid and myeloid precursors raise the possibility of copper deficiency anemia. If the diagnosis is delayed, the clinical course can be complicated by neurologic deficits.
Collapse
Affiliation(s)
- Thein Hlaing Oo
- The University of Texas M.D. Anderson Cancer Center Houston Texas USA
| | - Shimin Hu
- The University of Texas M.D. Anderson Cancer Center Houston Texas USA
| |
Collapse
|
54
|
D'Angelo G. Copper deficiency mimicking myelodysplastic syndrome. Blood Res 2016; 51:217-219. [PMID: 28090480 PMCID: PMC5234233 DOI: 10.5045/br.2016.51.4.217] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/25/2016] [Accepted: 12/13/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Guido D'Angelo
- Laboratory of Clinical-Chemistry, Hematology and Microbiology, ASST Valle Olona, Gallarate Hospital, Varese, Italy
| |
Collapse
|
55
|
Khera D, Sharma B, Singh K. Copper deficiency as a cause of neutropenia in a case of coeliac disease. BMJ Case Rep 2016; 2016:bcr2016214874. [PMID: 27635061 PMCID: PMC5030517 DOI: 10.1136/bcr-2016-214874] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2016] [Indexed: 01/04/2023] Open
Abstract
We report a 17 year-old male patient, who presented with chronic diarrhoea, progressive pallor, short stature, anaemia (haemoglobin of 4.9 g/dL) and neutropenia and was diagnosed as coeliac disease. His neutropenia did not respond to 8 months of gluten-free diet, iron, folic acid and vitamin B12 therapy. So we suspected copper deficiency and his serum copper levels were tested, which was low. His neutrophil counts normalised after 2 months of copper supplementation. Hence we concluded that the cause of neutropenia in our case was copper deficiency.
Collapse
Affiliation(s)
- Daisy Khera
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, India
| | - Baldev Sharma
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, India
| | - Kuldeep Singh
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, India
| |
Collapse
|
56
|
Rady K, Westerman D, Blombery P, Turner P, Seymour J. Copper deficiency mimicking myelodysplastic syndrome. Leuk Lymphoma 2015; 57:1223-6. [PMID: 26693885 DOI: 10.3109/10428194.2015.1086920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - David Westerman
- b Department of Pathology , Peter MacCallum Cancer Centre , East Melbourne , VIC , Australia ;,c Department of Medicine, University of Melbourne , Parkville , VIC , Australia
| | - Piers Blombery
- b Department of Pathology , Peter MacCallum Cancer Centre , East Melbourne , VIC , Australia
| | - Paul Turner
- d Department of Hematology , Austin Health , Heidelberg , VIC , Australia
| | - John Seymour
- a Department of Hematology ;,c Department of Medicine, University of Melbourne , Parkville , VIC , Australia
| |
Collapse
|
57
|
Öhrvik H, Logeman B, Noguchi G, Eriksson I, Kjellén L, Thiele DJ, Pejler G. Ctr2 Regulates Mast Cell Maturation by Affecting the Storage and Expression of Tryptase and Proteoglycans. THE JOURNAL OF IMMUNOLOGY 2015; 195:3654-64. [PMID: 26342034 DOI: 10.4049/jimmunol.1500283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 08/04/2015] [Indexed: 12/26/2022]
Abstract
Copper (Cu) is essential for multiple cellular functions. Cellular uptake of Cu(+) is carried out by the Ctr1 high-affinity Cu transporter. The mobilization of endosomal Cu pools is regulated by a protein structurally similar to Ctr1, called Ctr2. It was recently shown that ablation of Ctr2 caused an increase in the concentration of Cu localized to endolysosomes. However, the biological significance of excess endolysosomal Cu accumulation has not been assessed. In this study, we addressed this issue by investigating the impact of Ctr2 deficiency on mast cells, a cell type unusually rich in endolysosomal organelles (secretory granules). We show that Ctr2(-/-) mast cells have increased intracellular Cu concentrations and that the absence of Ctr2 results in increased metachromatic staining, the latter indicating an impact of Ctr2 on the storage of proteoglycans in the secretory granules. In agreement with this, the absence of Ctr2 caused a skewed ratio between proteoglycans of heparin and chondroitin sulfate type, with increased amounts of heparin accompanied by a reduction of chondroitin sulfate. Moreover, transmission electron microscopy analysis revealed a higher number of electron-dense granules in Ctr2(-/-) mast cells than in wild-type cells. The increase in granular staining and heparin content is compatible with an impact of Ctr2 on mast cell maturation and, in support of this, the absence of Ctr2 resulted in markedly increased mRNA expression, storage, and enzymatic activity of tryptase. Taken together, the present study introduces Ctr2 and Cu as novel actors in the regulation of mast cell maturation and granule homeostasis.
Collapse
Affiliation(s)
- Helena Öhrvik
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala 75123, Sweden;
| | - Brandon Logeman
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710
| | - Glyn Noguchi
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710
| | - Inger Eriksson
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala 75123, Sweden
| | - Lena Kjellén
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala 75123, Sweden
| | - Dennis J Thiele
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710; Department of Biochemistry, Duke University School of Medicine, Durham, NC 27710; and
| | - Gunnar Pejler
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala 75123, Sweden; Swedish University of Agricultural Sciences, Department of Anatomy, Physiology and Biochemistry, Uppsala 75651, Sweden
| |
Collapse
|
58
|
Merza H, Sood N, Sood R. Idiopathic hyperzincemia with associated copper deficiency anemia: a diagnostic dilemma. Clin Case Rep 2015; 3:819-22. [PMID: 26509015 PMCID: PMC4614648 DOI: 10.1002/ccr3.344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/14/2015] [Accepted: 07/29/2015] [Indexed: 11/12/2022] Open
Abstract
Prompt serum copper and zinc in addition to vitamin B12 levels should be measured in patients suffering from refractory anemia with neurological symptoms. A timely copper supplementation can help revert the hematological and possibly the neurological manifestations.
Collapse
Affiliation(s)
- Hussein Merza
- Department of Internal Medicine, Brooks Memorial Hospital Dunkirk, New York
| | - Neha Sood
- Division of Medical Oncology, CCS Oncology Dunkirk, New York
| | - Raman Sood
- Division of Medical Oncology, CCS Oncology Dunkirk, New York
| |
Collapse
|
59
|
Lee MJ, Alvarez JA, Smith EM, Killilea DW, Chmiel JF, Joseph PM, Grossmann RE, Gaggar A, Ziegler TR, Tangpricha V. Changes in Mineral Micronutrient Status During and After Pulmonary Exacerbation in Adults With Cystic Fibrosis. Nutr Clin Pract 2015; 30:838-43. [PMID: 26078287 DOI: 10.1177/0884533615589991] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients with cystic fibrosis (CF) may be at risk for micronutrient depletion, particularly during periods of illness and infection. The purpose of this study was to investigate serum micronutrient status over time in adults with CF initially hospitalized with a pulmonary exacerbation. MATERIALS AND METHODS This was an ancillary study of a multicenter trial investigating the role of high-dose vitamin D supplementation in 24 adults with CF (mean age, 29.6 ± 7.3 years). We measured serum concentrations of copper (Cu), iron (Fe), calcium (Ca), magnesium (Mg), potassium (K), and sulfur (S) in subjects at the beginning of a pulmonary exacerbation and again at 3 months. RESULTS Serum concentrations of Cu, Fe, and Ca were significantly lower at baseline compared with 3 months following the pulmonary exacerbation (Cu: baseline, 1.5 ± 0.6 vs 3 months, 1.6 ± 0.6 µg/mL, P = .027; Fe: 0.8 ± 0.3 vs 1.3 ± 1.1 µg/mL, P = .026; Ca: 9.7 ± 0.8 vs 10.8 ± 2.0 mg/dL, P = .024). Serum concentrations of K, Mg, and S did not change over time (K: baseline, 4.9 ± 0.3 vs 3 months, 5.1 ± 0.5 mEq/L; Mg: 1.8 ± 0.2 vs 2.0 ± 0.3 mg/dL; S: 1288.6 ± 343 vs 1309.9 ± 290 µg/mL; P > .05 for all). CONCLUSION Serum concentrations of Cu, Fe, and Ca increased significantly several months following recovery from acute pulmonary exacerbation in adults with CF. This may reflect decreased inflammation, improved food intake, and/or increased absorption following recovery.
Collapse
Affiliation(s)
- Moon Jeong Lee
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, and the Atlanta VA Medical Center, Atlanta, Georgia
| | - Jessica A Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, and the Atlanta VA Medical Center, Atlanta, Georgia Center for Clinical and Molecular Nutrition, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Ellen M Smith
- Nutrition & Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia
| | - David W Killilea
- Nutrition & Metabolism Center, Children's Hospital Oakland Research Institute, Oakland, California
| | - James F Chmiel
- Department of Pediatrics, Case Western Reserve University School of Medicine and Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Patricia M Joseph
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | | | - Amit Gaggar
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Thomas R Ziegler
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, and the Atlanta VA Medical Center, Atlanta, Georgia Center for Clinical and Molecular Nutrition, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Vin Tangpricha
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, and the Atlanta VA Medical Center, Atlanta, Georgia Center for Clinical and Molecular Nutrition, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia Nutrition & Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia
| | | |
Collapse
|
60
|
Xu C, Liao L, He Y, Wu R, Li S, Yang Y. Determination of copper (II) in foodstuffs based on its quenching effect on the fluorescence of N,N'-bis(pyridoxal phosphate)-o-phenylenediamine. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2015; 149:662-666. [PMID: 25985131 DOI: 10.1016/j.saa.2015.04.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 02/25/2015] [Accepted: 04/29/2015] [Indexed: 06/04/2023]
Abstract
A Schiff base-type fluorescence probe was prepared for the detection of copper (II) in foodstuffs. The probe is N,N'-bis(pyridoxal phosphate)-o-phenylenediamine (BPPP). It was synthesized by utilizing the Schiff base condensation reaction of pyridoxal 5-phosphate with 1,2-phenylenediamine. BPPP has the properties of high fluorescence stability, good water solubility and low toxicity. Its maximum excitation wavelength and maximum fluorescence emission wavelength are at 389 and 448 nm, respectively. When BPPP coexists with copper (II), its fluorescence is dramatically quenched. Under a certain condition, the fluorescence intensity decreased proportionally to the concentration of copper (II) by the quenching effect. Based on this fact, we established a fluorescence quenching method for the determination of copper (II). Under optimal conditions a linear range was found to be 0.5-50 ng/mL with a detection limit of 0.2 ng/mL. The method has been applied to determine copper (II) in foodstuff samples and the analytical results show good agreement with that obtained from atomic absorption spectrometry method.
Collapse
Affiliation(s)
- Canhui Xu
- College of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China
| | - Lifu Liao
- College of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China.
| | - Yunfei He
- College of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China
| | - Rurong Wu
- College of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China
| | - Shijun Li
- College of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China
| | - Yanyan Yang
- College of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China
| |
Collapse
|
61
|
Optic neuropathy, myelopathy, anemia, and neutropenia caused by acquired copper deficiency after gastric bypass surgery. J Clin Gastroenterol 2014; 48:862-5. [PMID: 24583748 DOI: 10.1097/mcg.0000000000000092] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Malabsorptive bariatric surgery is rapidly becoming a major cause of copper deficiency given the increasing prevalence of these procedures for morbid obesity. Acquired copper deficiency can present with clinically significant hematologic and neurological manifestations. Although hematologic manifestations of copper deficiency are rapidly reversible, significant neurological improvement after copper supplementation therapy is unusual and many patients remain debilitated and may only experience, at best, stabilization of the neurological manifestations. Here we present a case of an undiagnosed copper deficiency several years after bariatric gastric bypass surgery, in a patient who concomitantly used zinc-containing denture cream for several years, associated with anemia, neutropenia, myelopathy, respiratory failure, and bilateral optic neuropathy, which caused major vision loss. This patient was also a heterozygote carrier of the 5,10-methylenetetrahydrofolate reductase A1298C gene polymorphism, which may affect copper metabolism. Intravenous copper repletion resulted in rapid correction of hematologic indices. However, neurological manifestations, including vision loss responded only modestly to copper supplementation, despite achieving normal blood copper concentrations. Clinicians should consider copper deficiency in patients at risk, as in this case, as a delayed diagnosis can lead to irreversible disability due to neurological manifestations.
Collapse
|
62
|
Cytopenia and Bone Marrow Dysplasia in a Case of Wilson's Disease. Indian J Hematol Blood Transfus 2014; 30:433-6. [PMID: 25332639 DOI: 10.1007/s12288-014-0456-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 08/30/2014] [Indexed: 12/17/2022] Open
Abstract
We describe a sixteen year old with Wilson's disease on copper chelation and subsequent high dose oral zinc who developed severe anemia and neutropenia. Bone marrow aspirate done to evaluate the cause of bicytopenia revealed trilineage dysplasia. Correlating the clinical context with bone marrow and biochemical parameters, copper deficiency was suspected and he was given a trial of therapy, following which the hematological parameters improved. This case highlights hypocupremia as a reversible cause of bone marrow dysplasia in patients with Wilson's disease on chelation, where serum copper levels are not useful in the diagnosis. We also believe that monitoring of the blood counts in patients on copper chelation may provide a clue to impending copper deficiency.
Collapse
|
63
|
Stein J, Stier C, Raab H, Weiner R. Review article: The nutritional and pharmacological consequences of obesity surgery. Aliment Pharmacol Ther 2014; 40:582-609. [PMID: 25078533 DOI: 10.1111/apt.12872] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/22/2013] [Accepted: 06/21/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Obesity surgery is acknowledged as a highly effective therapy for morbidly obese patients. Beneficial short-term effects on common comorbidities are practically undisputed, but a growing data pool from long-term follow-up reveals increasing evidence of potentially severe nutritional and pharmacological consequences. AIMS To assess the prevalence, causes and symptoms of complications after obesity surgery, to elucidate and compare therapy recommendations for macro- and micronutrient deficiencies, and to explore surgically-induced effects on drug absorption and bioavailability, discussing ramifications for long-term therapy and prophylaxis. METHODS PubMed, Embase and MEDLINE were searched using terms including, but not limited to, bariatric surgery, gastric bypass, obesity surgery and Roux-en-Y, coupled with secondary search terms, e.g. anaemia, micronutrients, vitamin deficiency, bacterial overgrowth, drug absorption, pharmacokinetics, undernutrition. All studies in English, French or German published January 1980 through March 2014 were included. RESULTS Macro- and micronutrient deficiencies are common after obesity surgery. The most critical, depending on surgical technique, are hypoalbuminemia (3-18%) and deficiencies of vitamins B1 (≤49%), B12 (19-35%) and D (25-73%), iron (17-45%) and zinc (12-91%). Many drugs commonly administered to obese patients (e.g. anti-depressants, anti-microbials, metformin) are subject to post-operative and/or PPI-associated changes affecting bioavailability and absorption. CONCLUSIONS Complications are associated with pre-operative and/or post-operative malnutrition or procedure-related changes in intake, absorption and drug bioavailability. The high prevalence of nutrient deficiencies after obesity surgery makes life-long nutritional monitoring and supplementation essential. Post-operative changes to drug absorption and bioavailability in bariatric patients cast doubt on the validity of standard drug dosage and administration recommendations.
Collapse
Affiliation(s)
- J Stein
- Department of Gastroenterology and Clinical Nutrition, Sachsenhausen Hospital, Frankfurt/Main, Germany; German Obesity Center (GOC), Frankfurt-Sachsenhausen, Frankfurt/Main, Germany
| | | | | | | |
Collapse
|
64
|
Abstract
Pancytopenia occurring 1 year or later after allogeneic bone marrow transplantation typically prompts a primary consideration for relapse. We present the case of a 15-year old-girl who underwent transplantation for therapy-related myelodysplasia secondary to Ewing sarcoma treatment who developed pancytopenia with myelodysplasia 1 year after transplant due to copper deficiency. Copper deficiency is an important consideration in the evaluation of pancytopenia and myelodysplasia in pediatric patients.
Collapse
|
65
|
|
66
|
Pei D, Zhu F, Chen X, Qian J, He S, Qian Y, Shen H, Liu Y, Xu J, Shu Y. Pre-adjuvant chemotherapy leukocyte count may predict the outcome for advanced gastric cancer after radical resection. Biomed Pharmacother 2014; 68:213-7. [DOI: 10.1016/j.biopha.2014.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 01/20/2014] [Indexed: 12/29/2022] Open
|
67
|
Sakamaki Y, Goto K, Watanabe Y, Takata T, Yamazaki H, Imai N, Ito Y, Narita I. Nephrotic syndrome and end-stage kidney disease accompanied by bicytopenia due to copper deficiency. Intern Med 2014; 53:2101-6. [PMID: 25224196 DOI: 10.2169/internalmedicine.53.2338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 69-year-old man presented with proteinuria and hematuria. He had received total parenteral nutrition for massive small bowel resection. However, due to the iatrogenic lack of trace elements for the next four years, he developed severe copper-deficiency anemia and neutropenia. In addition, his proteinuria and kidney dysfunction worsened concurrently with the development of nephrotic syndrome and end-stage kidney disease. After receiving trace elements, the patient's anemia and neutropenia improved, and the anuria dramatically resolved. Copper-containing enzymes, including ceruloplasmin have an antioxidant activity. In patients with various types of glomerular injuries, the ceruloplasmin expression is known to be increased. Copper deficiency can worsen nephrotic syndrome by decreasing the ceruloplasmin activity, which protects the glomeruli.
Collapse
Affiliation(s)
- Yuichi Sakamaki
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | | | | | | | | | | | | | | |
Collapse
|
68
|
Thachil J, Owusu-Ofori S, Bates I. Haematological Diseases in the Tropics. MANSON'S TROPICAL INFECTIOUS DISEASES 2014. [PMCID: PMC7167525 DOI: 10.1016/b978-0-7020-5101-2.00066-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
69
|
Gratzinger D, Greenberg PL. Update on Myelodysplastic Syndromes Classification and Prognosis. Surg Pathol Clin 2013; 6:693-728. [PMID: 26839194 DOI: 10.1016/j.path.2013.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Myelodysplastic syndromes (MDS) are a collection of cytogenetically heterogeneous clonal bone marrow (BM) failure disorders derived from aberrant hematopoietic stem cells in the setting of an aberrant hematopoietic stem cell niche. Patients suffer from variably progressive and symptomatic bone marrow failure with a risk of leukemic transformation. Diagnosis of MDS has long been based on morphologic assessment and blast percentage as in the original French-American-British classification. The recently developed Revised International Prognostic Scoring System provides improved prognostication using more refined cytogenetic, marrow blast, and cytopenia parameters. With the advent of deep sequencing technologies, dozens of molecular abnormalities have been identified in MDS.
Collapse
Affiliation(s)
- Dita Gratzinger
- Department of Pathology, Stanford University Medical Center, 300 Pasteur Drive, L235, Stanford, CA 94305, USA.
| | - Peter L Greenberg
- Hematology Division, Stanford University Medical Center, 875 Blake Wilbur Drive, Stanford, CA 94305, USA
| |
Collapse
|
70
|
Cakic M, Mitic Z, Nikolic G, Savic I, Savic IM. Design and optimization of drugs used to treat copper deficiency. Expert Opin Drug Discov 2013; 8:1253-63. [PMID: 23919882 DOI: 10.1517/17460441.2013.825245] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Copper is an essential element in the human organism. Furthermore, copper deficiency is rare; however, the hematologic manifestations associated with copper deficiency, such as anemia, leukopenia, neutropenia, myeloneuropathy and osteoporosis, are well known. AREAS COVERED The authors present an overview of the various commercially available drugs used in the treatment of copper deficiency. Furthermore, the authors offer a description of copper complexes, as potential pharmaceutically active compounds, that can be used in the design of new formulations with therapeutic potential. EXPERT OPINION Progress in the synthesis of new metallo-organic complexes (such as the copper-pullulan complex) and the chelated form of copper have provided new avenues for drug design that combat copper deficiency. The copper-pullulan complex, as an active compound, has been designed in its solid dosage form, and its optimization in the treatment of copper deficiency has been furthered through advancements in experimental design methodology. The authors believe that the numerous ongoing studies, evaluating the synthesis of these complexes, should produce new additions to the copper deficiency therapeutic armamentarium in the future.
Collapse
Affiliation(s)
- Milorad Cakic
- University of Nis, Faculty of Technology, Department of Pharmaceutics , Bulevar oslobodjenja 124, 16000 Leskovac , Serbia +381 16 242859 ; +381 16 242859 ;
| | | | | | | | | |
Collapse
|
71
|
Zahran AM, Elsayh KI, El-Deek SEM, El-Baz MAH. Oxidative stress, trace elements, and circulating microparticles in patients with Gaucher disease before and after enzyme replacement therapy. Clin Appl Thromb Hemost 2013; 21:58-65. [PMID: 23698728 DOI: 10.1177/1076029613489595] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED We studied the level of lipid peroxide, nitric oxide (NO), trace elements (TEs), and microparticles (MPs) in Gaucher disease (GD) before and after 1 year of enzyme replacement therapy (ERT). A total of 15 children with GD and 15 healthy controls were enrolled in this study. Serum level of lipid peroxide, NO, and TEs was determined. The MPs were detected by flow cytometry. The level of lipid peroxide was significantly higher in the patients than in the controls even after ERT. Although NO level was normalized in the patients after ERT, zinc and copper were still lower in the patients after ERT. The percentages of various MPs were significantly higher in the patients than in the controls both before and after ERT. There were positive correlations between chitotriosidase and both lipid peroxide and total MPs. CONCLUSION The GD is associated with alteration in oxidant and antioxidant status and high level of circulating MPs.
Collapse
Affiliation(s)
- Asmaa M Zahran
- Department of Oncological Clinical Pathology, Flow Cytometry Lap, South Egypt Cancer Institute, Assiut University, Egypt
| | - Khalid I Elsayh
- Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
| | - Sahar E M El-Deek
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt
| | - Mona A H El-Baz
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt
| |
Collapse
|
72
|
Wolber FM, Beck KL, Conlon CA, Kruger MC. Kiwifruit and Mineral Nutrition. NUTRITIONAL BENEFITS OF KIWIFRUIT 2013; 68:233-56. [DOI: 10.1016/b978-0-12-394294-4.00013-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
73
|
Abstract
Copper is an essential trace metal that is required for the catalysis of several important cellular enzymes. However, since an excess of copper can also harm cells due to its potential to catalyze the generation of toxic reactive oxygen species, transport of copper and the cellular copper content are tightly regulated. This chapter summarizes the current knowledge on the importance of copper for cellular processes and on the mechanisms involved in cellular copper uptake, storage and export. In addition, we will give an overview on disturbances of copper homeostasis that are characterized by copper overload or copper deficiency or have been connected with neurodegenerative disorders.
Collapse
Affiliation(s)
- Ivo Scheiber
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | | | | |
Collapse
|
74
|
Affiliation(s)
- Anthony A Sochet
- Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA.
| | | | | | | |
Collapse
|
75
|
Abstract
Abstract
The term “unexplained anemia” appears frequently in a request for a hematology consultation. Although most anemia consultations are fairly routine, they occasionally represent challenging problems that require an amalgam of experience, insight, and a modicum of “out-of-the-box” thinking. Problem anemia cases and pitfalls in their recognition can arise for one of several reasons that are discussed in the cases presented herein. “Anemias beyond B12 and iron deficiency” covers a vast domain of everything that lies beyond the commonly encountered anemias caused by simple deficiencies of 2 currently major hematologically relevant micronutrients. However, even these deficiencies may be obscured when they coexist or are not considered because of misleading distractions. They may also be mistakenly identified when other less common nutrient deficiencies occur. I present herein case examples of such situations: a young patient with pancytopenia and schistocytes who was responsive to plasmapheresis, but in whom pernicious anemia was not suspected because of ethnicity and age; a bicytopenic patient with anemia and myelodysplastic features caused by copper deficiency after gastric reduction surgery; and a patient with BM hypoplasia and a dimorphic blood smear who was found to have paroxysmal nocturnal hemoglobinuria. These “pearls” represent but 3 examples of the many varieties of problems in anemia diagnosis and are used to illustrate potential pitfalls and how to avoid them.
Collapse
|
76
|
Jaiser SR, Winston GP. Subacute combined degeneration of the spinal cord despite prophylactic vitamin B12 treatment. J Clin Neurosci 2012; 19:1607. [DOI: 10.1016/j.jocn.2012.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 03/24/2012] [Indexed: 11/27/2022]
|
77
|
Pramyothin P, Kim DW, Young LS, Wichansawakun S, Apovian CM. Anemia and Leukopenia in a Long-Term Parenteral Nutrition Patient During a Shortage of Parenteral Trace Element Products in the United States. JPEN J Parenter Enteral Nutr 2012; 37:425-9. [DOI: 10.1177/0148607112463942] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pornpoj Pramyothin
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- The Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Dong Wook Kim
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Lorraine S. Young
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Sanit Wichansawakun
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- The Department of Medicine, Thammasat University, Bangkok, Thailand
| | - Caroline M. Apovian
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|