Top

Published in:

21-04-2023 | Macrocytic Anemia | Clinical Quiz

Severe anemia and massive proteinuria in a boy with diabetes mellitus: Answers

Authors: Gülşah Kaya Aksoy, Mustafa Koyun, Elif Çomak, Sema Akman

Published in: Pediatric Nephrology | Issue 9/2023

Excerpt

This boy had severe macrocytic anemia and leukopenia. The causes of macrocytic anemia are presented in detail in Table 1 [1]. Vitamin B12 deficiency, folate deficiency, and hypothyroidism were excluded because of normal laboratory results associated with these diseases. In a literature search for the association of macrocytic anemia and proteinuria, case reports with a diagnosis of copper deficiency attracted our attention [2, 3]. Serum copper level evaluated on this suspicion was found to be low (32 μg/dL, N 70–140 μg/dL). Therefore, the diagnosis is copper deficiency. …

Kliegman RM, Stanton B, St. Geme JW, Schor NF, Behrman RE, Blum NJ, Wilson K, Shah SS, Tasker RC (2020) Nelson textbook of pediatrics, 21st edn. Elsevier, Philadelphia

Sakamaki Y, Goto K, Watanabe Y, Takata T, Yamazaki H, Imai N, Ito Y, Narita I (2014) Nephrotic syndrome and end-stage kidney disease accompanied by bicytopenia due to copper deficiency. Intern Med 53:2101–2106CrossRefPubMed

Hirase N, Abe Y, Muta K, Sakamoto S, Nishimura J, Kimura Y, Nawada S, Minota S (1993) A case of copper deficiency with various clinical symptoms. Nippon Naika Gakkai Zasshi 10:275–276

Rempel J, Grover K, El-Matary W (2021) Micronutrient deficiencies and anemia in children with inflammatory bowel disease. Nutrients 15:236CrossRef

Bhalla A, Pannu AK (2022) Are Ayurvedic medications store house of heavy metals? Toxicol Res (Camb) 15:179–183CrossRef

Tahir N, Ashraf A, Waqar SHB, Rafae A, Kantamneni L, Sheikh T, Khan R (2022) Copper deficiency, a rare but correctable cause of pancytopenia: a review of literature. Expert Rev Hematol 15:999–1008CrossRefPubMed

Myint ZW, Oo TH, Thein KZ, Tun AM, Saeed H (2018) Copper deficiency anemia: review article. Ann Hematol 97:1527–1534CrossRefPubMed

Chan LN, Mike LA (2014) The science and practice of micronutrient supplementations in nutritional anemia: an evidence-based review. J Parenter Enteral Nutr 38:656–672CrossRef

Benkirane A, Warlop T, Ivanoiu A, Baret P, Wiame E, Haufroid V, Duprez T, Hantson P (2023) Case report: motor neuron disease phenotype associated with symptomatic copper deficiency: challenging diagnosis and treatment. Front Neurol 13:1063803CrossRefPubMedPubMedCentral

10.

Rosenberg M, Thapa S, Jeurkar C, Kasner M (2023) Copper deficiency mimicking myelodysplastic syndrome: zinc supplementation in the setting of COVID-19. Case Rep Oncol 7:55–61

11.

Fukasawa H, Furuya R, Kaneko M, Nakagami D, Ishino Y, Kitamoto S, Omata K, Yasuda H (2023) Clinical significance of trace element zinc in patients with chronic kidney disease. J Clin Med 12:1667CrossRefPubMedPubMedCentral

12.

Nishime K, Kondo M, Saito K, Miyawaki H, Nakagawa T (2020) Zinc burden evokes copper deficiency in the hypoalbuminemic hemodialysis patients. Nutrients 12:577CrossRefPubMedPubMedCentral

13.

Wahab A, Mushtaq K, Khan A, Khakwani MSK, Masood A, Henderson J, Malik F (2021) Zinc-induced hypocupremia and pancytopenia, from zinc supplementation to its toxicity, a case report. J Community Hosp Intern Med Perspect 11:843–846CrossRefPubMedPubMedCentral

14.

Tatineni V, An JY, Leffew MR, Mahesh SA (2020) Anemia from A to zinc: hypocupremia in the setting of gastric bypass and zinc excess. Clin Case Rep 26:745–750CrossRef

15.

Higuchi T, Matsukawa Y, Okada K, Oikawa O, Yamazaki T, Ohnishi Y, Fujita T, Fukuda N, Soma M, Matsumoto K (2006) Correction of copper deficiency improves erythropoietin unresponsiveness in hemodialysis patients with anemia. Intern Med 45:271–273CrossRefPubMed

16.

Munie S, Pintavorn P (2021) Erythropoietin-resistant anemia secondary to zinc-induced hypocupremia in a hemodialysis patient. Case Rep Nephrol Dial 11:167–175CrossRefPubMedPubMedCentral

17.

Altarelli M, Ben-Hamouda N, Schneider A, Berger MM (2019) Copper deficiency: causes, manifestations, and treatment. Nutr Clin Pract 34:504–513CrossRefPubMed

Title: Severe anemia and massive proteinuria in a boy with diabetes mellitus: Answers
Authors: Gülşah Kaya Aksoy
Mustafa Koyun
Elif Çomak
Sema Akman
Publication date: 21-04-2023
Publisher: Springer Berlin Heidelberg
Keywords: Macrocytic Anemia
Anemia
Nutrition
Leukopenia
Vitamin B12 Deficiency
Published in: Pediatric Nephrology / Issue 9/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-023-05972-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe anemia and massive proteinuria in a boy with diabetes mellitus: Answers

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 9/2023

Severe anemia and massive proteinuria in a boy with diabetes mellitus: Questions

Family functioning and quality of life among children with nephrotic syndrome during the first pandemic wave

Clinical features and outcomes of patients with diacylglycerol kinase epsilon nephropathy: a nationwide experience

Daily serum phosphate increase as early and reliable indicator of kidney injury in children with leukemia and lymphoma developing tumor lysis syndrome

The benefits of dietary fiber: the gastrointestinal tract and beyond

Early postoperative weight-based fluid overload is associated with worse outcomes after neonatal cardiac surgery