{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:25:05Z","timestamp":1777634705154,"version":"3.51.4"},"reference-count":23,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,17]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Hypocupremia is a rare and under-recognised cause of bone marrow dysplasia and myeloneuropathy. A 47-year-old Caucasian woman had progressive ascending peripheral neuropathy and gait ataxia over 3 months and fatigue, dyspnoea and unintentional weight loss over 8 months. She had profound macrocytic anaemia and neutropenia. Initial workup included normal serum vitamin B<jats:sub>12<\/jats:sub>. Bone marrow biopsy was suggestive of copper deficiency. Serum copper levels were later confirmed to be undetectable. The patient received oral copper repletion which resulted in complete normalisation of haematological abnormalities 16 weeks later. However, neurological deficits persisted. This case describes a delayed diagnosis of hypocupremia as initially suggested through invasive testing. Associating myeloneuropathy with cytopenia is imperative for accurate and prompt diagnosis of hypocupremia, which can be confirmed by serum analysis alone. Developing an accurate differential diagnosis can help prevent unnecessary procedures. Furthermore, initiating prompt copper repletion prevents further neurological impairment. Neurological deficits are often irreversible.<\/jats:p>","DOI":"10.1136\/bcr-2019-230025","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T05:43:04Z","timestamp":1575351784000},"page":"e230025","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Progressive myeloneuropathy with symptomatic anaemia"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-4996","authenticated-orcid":false,"given":"Charlene L","family":"Rohm","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA"},{"name":"Department of Graduate Medical Education, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Acree","sequence":"additional","affiliation":[{"name":"Department of Graduate Medical Education, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA"},{"name":"Department of Pathology, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Lovett","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA"},{"name":"Department of Graduate Medical Education, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"2025082707315042000_12.12.e230025.1","doi-asserted-by":"publisher","DOI":"10.4065\/81.10.1371"},{"key":"2025082707315042000_12.12.e230025.2","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181354294"},{"key":"2025082707315042000_12.12.e230025.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuro.2009.08.008"},{"key":"2025082707315042000_12.12.e230025.4","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000312375.79881.94"},{"key":"2025082707315042000_12.12.e230025.5","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1007\/s00277-018-3407-5","article-title":"Copper deficiency anemia: review article","volume":"97","author":"Myint","year":"2018","journal-title":"Ann Hematol"},{"key":"2025082707315042000_12.12.e230025.6","doi-asserted-by":"crossref","first-page":"2762","DOI":"10.1093\/jn\/135.12.2762","article-title":"Copper exposure induces trafficking of the Menkes protein in intestinal epithelium of ATP7A transgenic mice","volume":"135","author":"Monty","year":"2005","journal-title":"J Nutr"},{"key":"2025082707315042000_12.12.e230025.7","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M506727200"},{"key":"2025082707315042000_12.12.e230025.8","unstructured":"Turnland JR . 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