{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T02:54:06Z","timestamp":1771469646874,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2000,11,1]],"date-time":"2000-11-01T00:00:00Z","timestamp":973036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2000,11]]},"abstract":"<jats:p>Patients who develop cholestatic jaundice during chronic total parenteral nutrition (TPN) can develop significant hematologic complications due to hypocupremia if copper supplementation is withheld. A 36\u2010year\u2010old female with short bowel syndrome developed progressive liver dysfunction 6 months after initiation of TPN. Trace elements were omitted from her TPN because of cholestasis and persistent hyperbilirubinemia. Despite chronic diarrhea, absorption of some dietary copper was anticipated from her oral diet. Fifteen months later, the patient became red cell transfusion dependent, and her neutrophil and platelet counts steadily declined. After 19 months of receiving TPN without trace elements, her serum copper level was 25 \u03bcg\/dL (normal: 70 to 155 \u03bcg\/dL). Provision of trace elements for 2 months was associated with increased serum copper, neutrophil and platelet counts and independence from red cell transfusions. When the serum copper level reached 186 \u03bcg\/dL, copper supplementation was discontinued. Over the next 3 months, serum copper level fell to 10 \u03bcg\/dL, neutrophil and platelet counts fell precipitously, and red cell transfusions were resumed. Once again, copper, neutrophil and platelet levels promptly rebounded with parenteral copper supplementation. Although anemia and neutropenia are well\u2010recognized hematologic consequences of copper deficiency, thrombocytopenia rarely has been reported. This is the first report of pancytopenia secondary to TPN\u2010related copper deficiency in which the association was confirmed when hypocupremia recurred. <jats:italic>(Journal of Parenteral and Enteral Nutrition<\/jats:italic> 24:361\u2013366, 2000)<\/jats:p>","DOI":"10.1177\/0148607100024006361","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"361-366","source":"Crossref","is-referenced-by-count":81,"title":["Pancytopenia after Removal of Copper from Total Parenteral Nutrition"],"prefix":"10.1002","volume":"24","author":[{"given":"M. Patricia","family":"Fuhrman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Herrmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Masidonski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Eby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2000,11]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nu.08.070188.001315"},{"key":"e_1_2_1_3_1","first-page":"1430","volume-title":"Modern Nutrition in Health and Disease","author":"Shils ME","year":"1994"},{"key":"e_1_2_1_4_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1093\/ajcn\/49.3.573","article-title":"Trace element metabolism in adult patients requiring TPN","volume":"49","author":"Fleming R.","year":"1989","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_1_5_1","doi-asserted-by":"crossref","first-page":"952S","DOI":"10.1093\/ajcn\/67.5.952S","article-title":"Essentiality of copper in humans","volume":"67","author":"Uauy R.","year":"1998","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1985.10720069"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830110313"},{"key":"e_1_2_1_8_1","first-page":"118","article-title":"Copper deficiency in humans","volume":"20","author":"Williams DM","year":"1983","journal-title":"Sem Hematol"},{"key":"e_1_2_1_9_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1182\/blood.V28.2.280.280","article-title":"Hypocupremia and neutropenia in copper deficiency","volume":"28","author":"Cordano A.","year":"1966","journal-title":"Blood"},{"key":"e_1_2_1_10_1","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1001\/jama.1979.03290450049024","article-title":"Guidelines for essential trace element preparation for parenteral nutrition","volume":"241","author":"American Dietetic Association","year":"1979","journal-title":"JAMA"},{"key":"e_1_2_1_11_1","first-page":"209","volume-title":"Dietitian's Handbook of Enteral and Parenteral Nutrition","author":"Wong K.","year":"1998"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/97.5.665"},{"key":"e_1_2_1_13_1","first-page":"1054","article-title":"Copper deficiency and microcytic anemia resulting from prolonged ingestion of over\u2010the\u2010counter zinc","volume":"87","author":"Gyorffy EJ","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830480109"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000206060"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(72)80449-9"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-80-4-470"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197410102911526"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197407252910407"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.2830030209"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607186010005530"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607189013004421"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000204758"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607194018002190"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607199023003169"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.1995.tb01503.x"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0148607100024006361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:23:31Z","timestamp":1760865811000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0148607100024006361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,11]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2000,11]]}},"alternative-id":["10.1177\/0148607100024006361"],"URL":"https:\/\/doi.org\/10.1177\/0148607100024006361","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"value":"0148-6071","type":"print"},{"value":"1941-2444","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,11]]}}}