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Acquired copper deficiency following prolonged jejunostomy feeds
S Jayakumar1, P D Micallef-Eynaud, T D B Lyon
1Department of Thoracic Surgery, Hairmyres Hospital, East Kilbride G75 8RG, UK.
Annals of Clinical Biochemistry
|June 14, 2005
Summary
Copper deficiency anemia developed in a patient on long-term jejunostomy tube feeding. Oral intake restored copper levels, suggesting poor jejunostomy absorption of copper supplements.
Area of Science:
- Gastroenterology
- Hematology
- Nutritional Science
Background:
- Long-term enteral nutrition via jejunostomy tube is used for patients with esophageal strictures.
- Nutritional deficiencies can occur with prolonged jejunostomy feeding.
Observation:
- A 19-year-old male with esophageal lye stricture on eight months of jejunostomy feeding developed macrocytic anemia and leucopenia.
- Initial tests for vitamin B12, folate, and iron were normal.
- Bone marrow showed erythroid hyperplasia and vacuolization.
Findings:
- Low serum copper and ceruloplasmin confirmed copper deficiency anemia.
- Intravenous copper therapy provided intermittent improvement.
- Copper supplementation via jejunostomy tube failed to maintain adequate serum copper levels.
Implications:
- This case highlights potential malabsorption of copper supplements through jejunostomy tubes.
- Oral refeeding normalized copper levels, indicating copper sulfate is better absorbed orally.
- Careful monitoring of copper levels is crucial in patients on long-term jejunostomy feeding.