Anemia secondary to copper deficiency in a child receiving gastrojejunal feeds: A case report

Pediatric macrocytic anemia has a varied etiology, including nutritional deficiencies, such as folate or B12 deficiency, hematological factors, and micronutrient deficiencies, such as copper deficiency. We present the case of a 9-year-old girl with a complex medical history and gastrojejunal tube (G-J tube)-dependent nutrition who developed macrocytic anemia due to copper deficiency. Despite receiving enteral nutrition, her dietary copper intake was insufficient, leading to hematological abnormalities. Copper supplementation resulted in the normalization of hematological indices, highlighting the importance of considering trace element deficiencies in patients reliant on enteral nutrition, particularly in those receiving jejunal feeds. This case underscores the necessity for vigilant monitoring and optimized micronutrient supplementation in such patients given the lack of standardized guidelines for copper supplementation.