Idiopathic Copper Deficiency Induced Myeloneuropathy

Area of Science:

• Neurology
• Nutritional Science
• Internal Medicine

Background:

• Idiopathic nutritional deficiencies, particularly copper deficiency, are often missed in patients without malabsorption history.
• These deficiencies can lead to severe and potentially irreversible neurological dysfunction.

Observation:

• A 45-year-old male presented with acute encephalopathy, myeloneuropathy, and urinary incontinence, initially presumed as acute inflammatory demyelinating polyradiculopathy (AIDP).
• Initial workup was non-revealing, and the patient did not respond to plasmapheresis.
• Further investigation revealed low copper levels (0.45 µg/dL), along with deficiencies in vitamins A, E, and B1.

Findings:

• Intravenous copper infusion therapy led to a significant clinical response.
• Repeat copper levels increased to 0.71 µg/dL post-treatment.
• The patient showed marked improvement in neurological symptoms, including wrist drop and sensory disturbances.

Implications:

• Copper deficiency, despite being a trace element, can cause significant neurological impairment.
• Early diagnosis and supplementation are crucial for neurological recovery and improved quality of life.
• This case highlights the importance of considering nutritional deficiencies in unexplained neurological presentations.