Copper deficiency
Alerts and Notices
Synopsis
Copper is an important mineral in antioxidant activity, bone formation, melanin production, coagulation, and neurotransmitter synthesis. Its varied role highlights the varied phenotype of copper deficiency. Patients who are deficient in copper can present with abnormal fragile hair, ataxia, decreased skin pigmentation, muscle weakness, neuropathy, spastic paraparesis, diminished reflexes, bleeding disorders, anemia, and neutropenia. Blood work may reveal microcytic anemia and, in some cases, neutropenia.
Patients who have undergone gastric surgery (either gastrectomy or gastric bypass) are at risk for copper deficiency, as they may insufficiently mobilize copper from food sources due to limited acid exposure. Patients with small bowel malabsorption such as small bowel Crohn disease, celiac disease, or protein-losing enteropathies are also at an increased risk. Other populations in which to consider copper deficiency are chronic dialysis patients, premature infants on supplementary formula with no added copper, and patients taking excess zinc or chelating agents that may decrease copper's bioavailability.
See Menkes kinky hair syndrome for discussion of inherited copper deficiency.
Codes
ICD10CM:E61.0 – Copper deficiency
SNOMEDCT:
19577007 – Hypocupremia
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Differential Diagnosis & Pitfalls
- Vitamin B12 deficiency
- Folate deficiency
- Hypothyroidism
- Iron-deficiency anemia
- Myeloneuropathy
- Multiple sclerosis
- Neuromyelitis optica
- Transverse myelitis
- Neurosyphilis
- Lyme disease
- Subacute combined degeneration
- Myelodysplastic syndrome
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Last Reviewed:10/22/2018
Last Updated:10/30/2019
Last Updated:10/30/2019