Copper Deficiency (Hypocupremia) and Pancytopenia Late After Gastric Bypass Surgery

Robinson, Sara D.; Cooper, Barry; Leday, Temekka V.

doi:10.1080/08998280.2013.11929011

Cited by 27 publications

(23 citation statements)

References 16 publications

(20 reference statements)

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“…Such patients presented with hematological or neurological symptoms, usually many years after the operations (5-21 years). In those cases, copper supplementation proved effective against anemia and neutropenia, which resolved, but neurological symptoms did not usually show full recovery [26,27] . Awareness of the risk of copper deficiency over the long term after non-bariatric gastrectomy is therefore crucial.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Nakagawa

Kojima²,

Inokuchi³

et al. 2015

Dig Surg

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Background: Some recent reports have noted that copper deficiency can occur in obese patients who have undergone bariatric surgery, such as Roux-en-Y (RY) gastric bypass or biliopancreatic diversion, or in patients who receive enteral nutrition through a jejunostomy. No reports appear to have assessed the serum copper state of patients following gastrectomy with RY reconstruction for gastric cancer. Methods: A cross-sectional study was conducted from June 2013 to December 2014. Serum copper levels (SCLs) in 242 out-clinic patients who underwent curative gastrectomy were obtained. Patients were classified into an RY group (n = 208) and a non-RY group (n = 34). Results: Hypocupremia was identified in 3 patients in the RY group (1.4%), and 2 patients in the non-RY group (5.9%; p = 0.146), but none experienced any symptoms caused by hypocupremia. No significant difference in the mean SCL was seen between the RY group (105.8 ± 21.2 µg/dl) and non-RY group (107.9 ± 22.7 µg/dl; p = 0.499). In the RY group, the mean SCL was significantly lower in younger patients, patients with follow-up period <3 years, and male patients. Conclusion: Some patients developed hypocupremia after gastrectomy with RY reconstruction, but the number is acceptably low, and physical symptoms were unusual.

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Section: Discussionmentioning

confidence: 99%

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Nakagawa

Kojima²,

Inokuchi³

et al. 2015

Dig Surg

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“…Balsa et al 114 reported that 50.6% of 89 BPD patients had a low serum copper level at least once during a 5‐year period. In addition, numerous case reports have mentioned copper deficiency after RYGB 115 – 125 . Gletsu‐Miller et al 115 reported a 9.6% prevalence of copper deficiency in 136 RYGB patients.…”

Section: Vitamin and Mineral Supplementation And Potential Deficienciesmentioning

confidence: 99%

Nutrition and Metabolic Support Recommendations for the Bariatric Patient

et al. 2014

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Managing the metabolic needs of the patient with obesity is a challenge unto itself without the added demands of accounting for an altered gastrointestinal tract. Nevertheless, with about 200,000 bariatric procedures being performed annually in the United States, clinicians must be prepared to manage the critically ill bariatric surgery patient. This article reviews the recent literature relating to nutrient needs and metabolic support for the bariatric patient. Bariatric patients are at risk for several micronutrient deficiencies, including vitamins D and B₁₂, calcium, and iron; some bariatric procedures affect macronutrient needs as well. Literature on nutrition support guidelines for the bariatric population is limited. However, with an understanding of the anatomical and physiological effects of bariatric surgery, recent guidelines for critically ill patients with obesity can be applied to the bariatric surgery population. The unique needs of the bariatric population, such as susceptibility to micronutrient deficiencies and specialized access routes, must be considered to provide safe and efficacious nutrition support. Further research is necessary to develop specific nutrition support recommendations for the bariatric population.

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“…32 The complications of human copper deficiency such as anemia, pancytopenia, and ataxia are common following bypass surgery. 33 It is critical to detect deficiency before the neurological phenotype is expressed, because treatment often does not help. The goal, therefore, is to develop good sensitive biomarkers of copper status so deficiency can be treated.…”

Section: Copper Biomarkersmentioning

confidence: 99%

Impact of copper deficiency in humans

Prohaska

2014

Annals of the New York Academy of Sciences

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Humans consume about 1 mg of copper daily, an amount thought adequate for most needs. Genetic, environmental, or physiological alterations can impose a higher copper set point, increasing risk for copper-limited pathophysiology. Humans express about a dozen proteins that require copper for function (cuproenzymes). Limitation in the activity of cuproenzymes can explain the pleiotropic effect of copper deficiency. However, for most of the salient features of human copper deficiency, the precise molecular mechanisms are unknown. This is true for the two most common clinical features, hypochromic anemia and adult onset peripheral neuropathy/ataxia, a condition described frequently in the last decade due to multiple etiologies. The challenge for future scientists will be to identify the mechanisms underlying the pathophysiology of copper deficiency so appropriate screening and treatment can occur. The need for a strong copper biomarker to aid in this screening is critical.

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Copper Deficiency (Hypocupremia) and Pancytopenia Late After Gastric Bypass Surgery

Cited by 27 publications

References 16 publications

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Assessment of Serum Copper State after Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Nutrition and Metabolic Support Recommendations for the Bariatric Patient

Impact of copper deficiency in humans

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