{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T19:54:08Z","timestamp":1779220448626,"version":"3.51.4"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,9,1]]},"abstract":"<jats:p>Copper deficiency can cause bone lesions in infants, which might be confused with child abuse. Two extremely low birth weight preterm infants had complicated medical courses requiring prolonged parenteral nutrition for short-gut syndrome, which led to the development of cholestasis. Both had spent their entire lives in the hospital. They had been on prolonged ventilator support for chronic lung disease. They developed signs of copper deficiency between 5 and 6 months of age, initially raising child abuse concerns. Musculoskeletal discomfort led to the recognition of radiographic findings of metabolic bone disease. Included were osteoporosis, metaphyseal changes, and physeal disruptions. Copper levels were low; both low copper parenteral nutrition and gut losses from refeeding diarrhea likely contributed to their deficiency. Therapeutic supplementation with copper corrected their deficits and clinical and radiologic findings. The information from these cases, in particular, their radiologic findings, indicate the need to monitor copper status in at-risk premature infants. These findings may aid prevention and earlier recognition of copper deficiency. Their specific radiologic and clinical findings should aid differentiation of such children from abused infants.<\/jats:p>","DOI":"10.1542\/peds.2011-1295","type":"journal-article","created":{"date-parts":[[2012,8,7]],"date-time":"2012-08-07T00:26:13Z","timestamp":1344299173000},"page":"e695-e698","source":"Crossref","is-referenced-by-count":47,"title":["Copper Deficiency Presenting as Metabolic Bone Disease in Extremely Low Birth Weight, Short-Gut Infants"],"prefix":"10.1542","volume":"130","author":[{"given":"Michelle L.","family":"Marquardt","sequence":"first","affiliation":[{"name":"Departments of Pediatrics-Graduate Medical Education,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen L.","family":"Done","sequence":"additional","affiliation":[{"name":"Radiology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maura","family":"Sandrock","sequence":"additional","affiliation":[{"name":"Clinical Nutrition, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter E.","family":"Berdon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Children\u2019s Hospital of New York, Columbia University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth W.","family":"Feldman","sequence":"additional","affiliation":[{"name":"General Pediatrics, Seattle Children\u2019s Hospital, The University of Washington School of Medicine, Seattle, Washington; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2012,9,1]]},"reference":[{"issue":"4","key":"2021120823531809400_B1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1136\/adc.63.4.448","article-title":"Copper deficiency and non-accidental injury.","volume":"63","author":"Shaw","year":"1988","journal-title":"Arch Dis Child"},{"issue":"3","key":"2021120823531809400_B2","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1007\/BF01963553","article-title":"Copper and liver disease.","volume":"150","author":"Danks","year":"1991","journal-title":"Eur J Pediatr"},{"issue":"5","key":"2021120823531809400_B3","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1093\/ajcn\/48.5.1324","article-title":"Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition.","volume":"48","author":"Greene","year":"1988","journal-title":"Am J Clin Nutr"},{"issue":"2","key":"2021120823531809400_B4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/0884533608314529","article-title":"Correlation of cholestasis with serum copper and whole-blood manganese levels in pediatric patients.","volume":"23","author":"McMillan","year":"2008","journal-title":"Nutr Clin Pract"},{"issue":"4","key":"2021120823531809400_B5","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1006\/jfca.2000.0986","article-title":"Mineral concentrations in cow\u2019s milk from the Canary Island.","volume":"14","author":"Rodriguez","year":"2001","journal-title":"J Food Compos Anal."},{"issue":"679","key":"2021120823531809400_B6","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1259\/0007-1285-57-679-636","article-title":"Epiphyseal separation simulating pyarthrosis, secondary to copper deficiency, in an infant receiving total parenteral nutrition.","volume":"57","author":"Levy","year":"1984","journal-title":"Br J Radiol"},{"issue":"3","key":"2021120823531809400_B7","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1079\/PNS19740050","article-title":"Trace elements in foetal and early postnatal development.","volume":"33","author":"Widdowson","year":"1974","journal-title":"Proc Nutr Soc"},{"issue":"2","key":"2021120823531809400_B8","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1148\/112.2.401","article-title":"Kinky-hair syndrome: serial study of radiologic findings with emphasis on the similarity to the battered child syndrome.","volume":"112","author":"Adams","year":"1974","journal-title":"Radiology."},{"issue":"3","key":"2021120823531809400_B9","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/01.pec.0000117923.65522.6f","article-title":"Child abuse in infants with proximal physeal injuries of the femur.","volume":"20","author":"Jones","year":"2004","journal-title":"Pediatr Emerg Care"},{"issue":"7","key":"2021120823531809400_B10","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1136\/adc.60.7.644","article-title":"Copper deficiency in the preterm infant of very low birthweight. 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