Recruitment lecture 12.13.2019

Today’s noon conference was about a young patient with anorexia presenting with neutropenia, leukopenia and macrocytic anemia. Smear showed sideroblasts. After ruling out viral and some nutritional deficiencies, BM was considered but further history eluded to significant use of zinc lozenges which caused copper deficiency. They were treated with oral copper and counts improved. Further information on the slides neutropenia – 12.13 and in this case from NEJM nejmcps1811547


Take home points:

  • Know how to evaluate neutropenia and macrocytic anemia
  • Getting a good history, including med rec (and OTCs!) can make the case
  • Copper deficiency can present exactly like B12 deficiency
  • Think about copper deficiency in people with malabsorption / malnutrition




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