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Pediatr Blood Cancer. 2017 May 5. doi: 10.1002/pbc.26617. [Epub ahead of print]

Refractory cytopenias secondary to copper deficiency in children receiving exclusive jejunal nutrition.

Author information

1
Division of Pediatric Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio.
2
Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio.
3
Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio.
4
Department of Pathology, Ohio State University College of Medicine, Columbus, Ohio.
5
Division of Pediatric Hematology/Oncology, Hasbro Children's Hospital, Providence, Rhode Island.
6
Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Abstract

Copper deficiency is a known cause of anemia and neutropenia that is easily remedied with copper supplementation. Copper is primarily absorbed in the stomach and proximal duodenum, so patients receiving enteral nutrition via methods that bypass this critical region may be at increased risk for copper deficiency. In pediatrics, postpyloric enteral feeding is increasingly utilized to overcome problems related to aspiration, severe reflux, poor gastric motility, and gastric outlet obstruction. However, little is known about the prevalence of copper deficiency in this population. We describe three pediatric patients receiving exclusive jejunal feeds who developed cytopenias secondary to copper deficiency.

KEYWORDS:

MDS; copper deficiency; gastrojejunostomy; jejunostomy; myelodysplasia; nutritional anemia; nutritional deficiencies; pancytopenia

PMID:
28475294
DOI:
10.1002/pbc.26617
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