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Serum and rectal mucosal copper status in acute and chronic diarrhea
H P Sachdev1, N K Mittal, H S Yadav
1Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
Insights
Children with chronic diarrhea show depleted copper levels, while acute diarrhea may cause a temporary, non-specific increase. Prolonged diarrhea leads to progressive copper loss in young children.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Biochemistry
- Infectious Diseases
Background:
- Copper is an essential trace element vital for numerous physiological processes.
- Diarrheal diseases are a major cause of morbidity and mortality in infants and young children globally.
- Altered trace element status, including copper, has been implicated in the pathophysiology of diarrhea.
Purpose of the Study:
- To investigate serum and rectal mucosal copper levels in children with acute and chronic diarrhea compared to controls.
- To determine the relationship between copper status and the duration of diarrhea.
- To assess changes in copper levels during and after treatment for diarrhea.
Main Methods:
- Cross-sectional study comparing copper levels in children aged 6-18 months with acute diarrhea, chronic diarrhea, extraintestinal infections, and healthy controls.
- Serum and rectal mucosal copper content were measured.
- Correlation analysis was performed between serum copper and diarrheal duration.
- Copper levels were re-evaluated at discharge and follow-up.
Main Results:
- Serum copper was significantly higher in acute diarrhea and infected controls compared to chronic diarrhea and healthy controls.
- Rectal mucosal copper was significantly lower in children with chronic diarrhea.
- A significant negative correlation was observed between serum copper and diarrheal duration.
- Copper levels decreased during illness and showed partial recovery post-treatment, with chronic diarrhea patients exhibiting a more pronounced depletion.
Conclusions:
- Elevated serum copper in acute diarrhea is likely a non-specific response to infection.
- Infants with chronic diarrhea present with copper depletion, unlike those with acute diarrhea.
- Continuous diarrhea leads to progressive depletion of copper reserves in children.
Abstract:
Serum and rectal mucosal copper content was estimated in children (6-18 months old) with acute diarrhea (group I: n = 50), chronic diarrhea (group II: n = 25), extraintestinal infections (group III: n = 15), and apparently healthy controls (group IV: n = 20). The sex and nutritional status of various groups was comparable. The mean serum copper levels in acute diarrhea and infected control groups were comparable, but significantly (p less than 0.001) greater in comparison to chronic diarrhea and healthy control groups. The tissue copper in group II was significantly (p less than 0.001) lower than other groups, which were comparable. There was a significant negative correlation between serum copper and diarrheal duration (r = -0.615; p less than 0.001). Repeat estimation at discharge in 38 patients (25 in group I and 13 in group II) revealed a significant (p less than 0.05) reduction in the serum and tissue copper content during this period. Among the 23 infants (16 in group I and 7 in group II) evaluated 2-3 weeks after discharge, there was an increase in copper values of tissue alone (p less than 0.05) in group I and both serum and tissue (p less than 0.05) in group II. It is concluded that elevation of serum copper in acute diarrhea is a nonspecific response to infection; infants with chronic but not acute diarrhea are copper depleted at presentation; and with the continuation of diarrhea, there is a progressive depletion of copper.