[Peripheral neuropathy, myelopathy, cerebellar ataxia, and subclinical optic neuropathy associated with copper deficiency occurring 23 years after total gastrectomy].

Abstract

We report a 61-year-old man with slowly progressive gait disturbance and paresthesia in the lower extremities following a total gastrectomy for gastric cancer 23 years previously. The patient presented with hyperreflexia, peripheral sensory neuropathy, and cerebellar ataxia. Magnetic resonance imaging showed atrophy of the cerebellum, and electrophysiological findings suggested the presence of disorder in both sides of the pyramidal tract, dorsal column, peripheral nerves, and optic nerve. Laboratory findings revealed anemia, neutropenia, and a remarkably low serum copper level (10 microg/dl; normal: 68-128). His serum vitamin E was slightly low and his serum vitamin B12 was within the normal limits. After administering an oral copper supplement, his symptoms improved with normalization of the serum copper level. We need to pay attention to myeloneuropathy caused by copper deficiency if the patient has a past history of total gastrectomy.

• Authors: Meiko Inaba, Takako Torii, Koji Shinoda, Ryo Yamasaki, Yasumasa Ohyagi, Jun-ichi Kira
• Journal: Rinsho shinkeigaku = Clinical neurology (Rinsho Shinkeigaku) Vol. 51 Issue 6 Pg. 412-6 (Jun 2011) ISSN: 0009-918X [Print] Japan
• PMID: 21735733 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Copper

Topics

• Copper (deficiency)
• Dermatitis, Seborrheic (complications)
• Gastrectomy (adverse effects)
• Hair Diseases (complications)
• Humans
• Intracranial Arteriosclerosis (etiology)
• Male
• Metabolism, Inborn Errors (complications)
• Middle Aged
• Optic Nerve Diseases (etiology)
• Peripheral Nervous System Diseases (etiology)
• Postoperative Complications
• Seizures (complications)
• Spinal Cord Diseases (etiology)
• Stomach Neoplasms (surgery)
• Time Factors