Case Presentation: A female patient was referred to hematology/oncology with severe neutropenia and leukopenia. Bone marrow biopsy revealed ringed sideroblasts with multilineage dysplasia consistent with MDS. Further diagnostic workups did not reveal common genetic mutations, and she was scheduled to start treatment with either erythropoietin or luspatercept. Copper deficiency was later found in follow-up, which [...]