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BMJ Case Rep. 2017 Sep 26;2017. pii: bcr-2017-220921. doi: 10.1136/bcr-2017-220921.

Copper deficiency caused by excessive alcohol consumption.

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Department of Emergency and General Internal Medicine, Hitachinaka General Hospital, Hitachinaka, Ibaraki, Japan.
Department of General Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan.
Department of Nephrology, Suwa Central Hospital, Chino, Nagano, Japan.
Department of Gastroenterology and Internal Medicine, Suwa Central Hospital, Chino, Nagano, Japan.


Copper deficiency is a disease that causes cytopaenia and neuropathy and can be treated by copper supplementation. Long-term tube feeding, long-term total parenteral nutrition, intestinal resection and ingestion of zinc are known copper deficiency risk factors; however, alcohol abuse is not. In this case, a 71-year-old man had difficulty waking. He had a history of drinking more than five glasses of spirits daily. He was well until 3 months ago. A month before his visit to our hospital, he could not eat meals but continued drinking. He had macrocytic anaemia on admission. Copper and ceruloplasmin levels were markedly low, and we diagnosed copper deficiency. There were no other known risk factors for copper deficiency. After he began drinking cocoa as a copper supplement, the anaemia ameliorated and he was able to walk. This is the first report showing alcohol abuse as a risk factor for copper deficiency.


alcoholic liver disease; diet; haematology (incl blood transfusion); peripheral nerve disease

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