ABSTRACT
CNS demyelination is not a previously reported feature of acquired copper deficiency. The authors report two patients with idiopathic hypocupremia and hyperzincemia, hematologic changes of copper deficiency, and extensive CNS demyelination. Hematologic recovery followed copper supplementation, both initially and after relapse off copper therapy, while serum zinc levels remained high and the neurologic abnormalities only stabilized.
Subject(s)
Copper/deficiency , Demyelinating Diseases/blood , Demyelinating Diseases/etiology , Zinc/blood , Brain/pathology , Demyelinating Diseases/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle AgedABSTRACT
Described are two patients whose initial symptom was acute respiratory failure requiring mechanical ventilation. Initially, the cause of the respiratory failure in each patient was obscure, but diaphragmatic paralysis was subsequently demonstrated fluoroscopically in each case. Further neurologic evaluation then supported the diagnosis of amyotrophic lateral sclerosis. Postmortem examination corroborated this diagnosis.