{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:27:11Z","timestamp":1789770431429,"version":"4.0.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,9,1]],"date-time":"2006-09-01T00:00:00Z","timestamp":1157068800000},"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":[[2006,9]]},"abstract":"<jats:p><jats:italic>Background:<\/jats:italic> In animal studies, copper absorption has been demonstrated to occur in the proximal gut <jats:italic>via<\/jats:italic> duodenal enterocytes. Acquired copper deficiency is known as \u201cswayback\u201d in ruminant animals and Menkes' disease in humans. Copper is an essential micronutrient necessary for the hematologic and neurologic systems. Acquired copper deficiency in humans has been described, causing a syndrome similar to the subacute combined degeneration of vitamin B<jats:sub>12<\/jats:sub> deficiency. <jats:italic>Methods:<\/jats:italic> This is a single case report. Our patient developed a neurologic constellation of ataxia, myelopathy, and peripheral neuropathy similar to vitamin B<jats:sub>12<\/jats:sub> deficiency many years after gastrectomy for severe peptic ulcer disease. The patient was maintained for decades with enteral feedings <jats:italic>via<\/jats:italic> jejunostomy that provided the recommended dietary allowance (RDA) for copper. <jats:italic>Results:<\/jats:italic> Copper deficiency was suspected, identified, and treated. Over 3 months of follow\u2010up, serum copper levels increased from 4 \u03bcg\/dL to 20 \u03bcg\/dL (70\u2013150 \u03bcg\/dL), and ceruloplasmin increased from 6 mg\/dL to 8 mg\/dL (14\u201358 mg\/dL). During this short time of follow\u2010up, the patient has had no further progression of his neurologic symptoms. <jats:italic>Conclusions:<\/jats:italic> Ataxia and myelopathy secondary to acquired copper deficiency are rare complications of major gastric resection. This is quite similar to the syndrome of vitamin B<jats:sub>12<\/jats:sub> deficiency. Vitamin B<jats:sub>12<\/jats:sub> repletion does not improve symptoms. Bariatric procedures such as gastric bypass surgery result in a similar functional anatomy of the proximal gut and may place more patients at increased risk. Early recognition and therapy with oral or parenteral copper may lead to a decrease in both neurologic and hematologic consequences.<\/jats:p>","DOI":"10.1177\/0148607106030005446","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"446-450","source":"Crossref","is-referenced-by-count":96,"title":["Severe Ataxia, Myelopathy, and Peripheral Neuropathy Due to Acquired Copper Deficiency in a Patient With History of Gastrectomy"],"prefix":"10.1002","volume":"30","author":[{"given":"Jeremias C.","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Burns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Royden","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,9]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.12.1782"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.5.762"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-3322(03)00012-X"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000073542.02761.5F"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000132644.52613.FA"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00546-4"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1258\/0004563053492829"},{"key":"e_1_2_4_9_1","first-page":"224","volume-title":"Recommended Dietary Allowances.","author":"National Research Council","year":"1989"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.1988.tb09595.x"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000032497.30439.F6"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/86.2.120"},{"key":"e_1_2_4_13_1","doi-asserted-by":"crossref","first-page":"960S","DOI":"10.1093\/ajcn\/67.5.960S","article-title":"Human whole\u2010body copper metabolism","volume":"67","author":"Turnlund JR.","year":"1998","journal-title":"Am J Clin Nutr."},{"key":"e_1_2_4_14_1","first-page":"450","article-title":"Neurological disorders in patients following surgery for peptic ulcer [letter]","volume":"22","author":"Hoffman PM","year":"1972","journal-title":"Neurology."},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.37.2.196"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1971.tb07503.x"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.2.481"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1381\/0960892054222759"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2004.12.045"},{"key":"e_1_2_4_20_1","first-page":"S50","article-title":"Symptomatic hypocupremia post\u2010Roux\u2010en\u2010Y gastric bypass for morbid obesity [abstract]","volume":"30","author":"Deppe LM","year":"2006","journal-title":"JPEN J Parenter Enteral Nutr."}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0148607106030005446","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0148607106030005446","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0148607106030005446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:04:00Z","timestamp":1760864640000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0148607106030005446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,9]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2006,9]]}},"alternative-id":["10.1177\/0148607106030005446"],"URL":"https:\/\/doi.org\/10.1177\/0148607106030005446","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"value":"0148-6071","type":"print"},{"value":"1941-2444","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,9]]}}}