Copper Deficiency Anemia Due to Low-Calorie, Blended Enteral Diet: Case Report

Copper deficiency is an uncommon cause of hematologic abnormalities in children that is often overlooked or misdiagnosed. When found, specific recommendations on dose, duration, or frequency of copper repletion are lacking in the current literature. This report describes the case of a 4-year-old boy who presented to a university medical center in the midwestern United States with persistent macrocytic anemia found to be caused by copper deficiency secondary to a low-calorie, blended enteral diet. Intravenous copper supplementation was initiated at 40 μg/kg/d for a total of 6 days, followed by enteral supplementation of 2 mg cupric oxide. This repletion regimen ultimately improved the patient's copper deficiency and resolved anemia within 1 month.