Document Detail


Acute and bilateral blindness due to optic neuropathy associated with copper deficiency.
MedLine Citation:
PMID:  19667226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acquired copper deficiency in adults is associated with a subacute to chronic progressive myeloneuropathy and optic neuropathy.
OBJECTIVE: To describe an individual after gastric bypass surgery who developed a chronic progressive myeloneuropathy, an acute optic neuropathy, along with anemia and leukopenia.
DESIGN: Case report.
SETTING: Academic center. Patient A 55-year-old woman, following gastric bypass surgery 22 years earlier, developed progressive numbness, weakness, and sphincter disturbance over 6 years. She awoke one morning with bilateral blindness. Examination findings showed evidence of severe myelopathy and peripheral neuropathy.
MAIN OUTCOME MEASURES: Magnetic resonance imaging, optical coherence tomography, electrophysiologic studies, nerve and muscle biopsy specimens, and vision testing.
RESULTS: Over 1 year of follow-up, copper infusion therapy seemed to stabilize the progressive myeloneuropathy and improved leukopenia and anemia. It had no effect on the optic neuropathy. Optic nerve tissue injury was observed on magnetic resonance diffusion tensor imaging and on optical coherence tomography.
CONCLUSIONS: Copper deficiency should be considered in cases of atypical optic neuropathy. Serum copper levels should be monitored in patients with a compatible neurologic syndrome who have undergone gastric bypass surgery. Although visual acuity did not improve after copper infusion in our patient, prompt recognition of copper deficiency may prevent further deterioration.
Authors:
Robert T Naismith; James B Shepherd; Conrad C Weihl; Nhial T Tutlam; Anne H Cross
Related Documents :
17651476 - Computerized tomography myelography with coronal and oblique coronal view for diagnosis...
15137616 - Sciatic nerve sarcoidosis: utility of magnetic resonance peripheral nerve imaging and t...
12208726 - Rapid and durable recovery of visual function in a patient with von hippel-lindau syndr...
19667226 - Acute and bilateral blindness due to optic neuropathy associated with copper deficiency.
17978036 - More is not always better: increased fractional anisotropy of superior longitudinal fas...
15876956 - Multifocal bone marrow involvement in cat-scratch disease.
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Archives of neurology     Volume:  66     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-08-20     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1025-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Washington University, Campus Box 8111, 660 S Euclid Ave, St Louis, MO 63110, USA. naismithr@neuro.wustl.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anemia / etiology
Blindness / etiology*
Copper / administration & dosage,  deficiency*
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging
Female
Gastric Bypass
Humans
Leukoplakia, Oral / etiology
Middle Aged
Neurologic Examination
Optic Nerve / pathology
Optic Nerve Diseases / etiology*
Postoperative Complications / etiology
Spinal Cord Diseases / etiology
Tomography, Optical Coherence
Grant Support
ID/Acronym/Agency:
CA1012/CA/NCI NIH HHS; K08AG026271-01/AG/NIA NIH HHS; K12RR02324902/RR/NCRR NIH HHS; K23 NS052430-03/NS/NINDS NIH HHS; K23NS052430-01A1/NS/NINDS NIH HHS; K24 RR017100/RR/NCRR NIH HHS; K24 RR017100/RR/NCRR NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 TR000448/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
7440-50-8/Copper
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Atypical progressive multifocal leukoencephalopathy associated with an unusual JC polyomavirus mutat...
Next Document:  Mitochondrial neurogastrointestinal encephalopathy due to mutations in RRM2B.