Severe Anemia and Neutropenia Associated with Copper Deficiency in Three elderly Adults Residing in Nursing Homes.

This report describes three cases of severe anemia and neutropenia associated with copper deficiency. All patients were octogenarian women who presented with cognitive impairment and resided in nursing homes. The rapid response to low-dose oral copper supplementation indicates that their copper deficiency was caused by a poor intake rather than the malabsorption of copper. This case series demonstrates that severe copper deficiency can occur in the absence of typical underlying conditions, such as gastrointestinal surgery or an excessive zinc intake. Our experience suggests incorporating serum copper measurements into the diagnostic work-up of elderly patients with unexplained cytopenia.