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A 62\u2010year\u2010old patient with systemic sclerosis who was dependent on home PN due to intestinal dysmotility developed anemia and leukopenia approximately 4 months after parenteral copper was withheld from her PN solution due to drug shortages. The patient was not able to tolerate a sufficient amount of oral multivitamins with trace elements due to severe dysphagia. Her serum copper and ceruloplasmin concentrations were undetectable, confirming the diagnosis of severe copper deficiency. The hematological abnormalities promptly resolved with copper supplementation. This report emphasizes the importance of close monitoring for nutrient deficiencies during drug shortages and supplementing with oral or enteral nutrition when feasible, particularly in high\u2010risk patients such as those with intestinal malabsorption or short bowel syndrome who are dependent on long\u2010term PN.<\/jats:p>","DOI":"10.1177\/0148607112463942","type":"journal-article","created":{"date-parts":[[2012,10,16]],"date-time":"2012-10-16T01:59:46Z","timestamp":1350352786000},"page":"425-429","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Anemia and Leukopenia in a Long\u2010Term Parenteral Nutrition Patient During a Shortage of Parenteral Trace Element Products in the United States"],"prefix":"10.1002","volume":"37","author":[{"given":"Pornpoj","family":"Pramyothin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Wook","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine S.","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanit","family":"Wichansawakun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Apovian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,15]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"American Society of Health\u2010System Pharmacists (ASHP).Current drug shortage bulletins: trace elements injection.2011.http:\/\/www.ashp.org\/DrugShortages\/Current\/Bulletin.aspx?id=785. 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