Background: Copper is an essential trace element in the human body acting as a cofactor in many enzymatic reactions. Notably copper is involved in iron metabolism, neurohormone homeostasis, production of collagen, electron transport, regulation of gene expression, immune system function and melanin production. Two diseases that have been well documented in regards to copper regulation [...]

Case Presentation: A 55-year-old man with a history of chronic alcohol abuse, anxiety, and Crohn’s disease treated with right hemicolectomy and ileocolic anastomosis 30 years ago presented with symptoms of altered mental status, generalized weakness, and weight loss for 10 days. He endorsed chronic diarrhea but was not on immunosuppressants. He had a temperature of [...]

Case Presentation: Our patient is a 37-year-old gentleman with history of colonic Burkitt’s Lymphoma, in remission since 2010, eosinophilic colitis (on a prolonged steroid taper), CMV colitis, and common variable immunodeficiency, who presented with acute on chronic diarrhea. He incidentally noted worsening bilateral lower extremity weakness over the past 2 years, requiring the use of [...]

Case Presentation: A 96-year-old previously healthy Japanese man with a history of pancytopenia presented to our ED in May 2023 with ascending numbness and paresthesia. Over 1.5 months, he steadily developed numbness and tingling that ascended to his chest level (T4). He initially presented to an outside ED and received a CT T-spine that showed [...]

Case Presentation: A 54-year-old male with a history of Roux-en-Y gastric bypass surgery 12 years prior presented to the ED after labs showed a new pancytopenia from eight months prior. He reported fatigue but denied fevers, weight loss, dyspnea, bleeding, or recent infections. Medical history was notable for myocarditis 20 years ago and cholecystectomy 1 [...]

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 [...]

Case Presentation: Patient is a 57-year-old female with past medical history significant for alcohol use disorder who presented to an outside facility with one month history of bilateral lower extremity (BLE) weakness associated with nausea, vomiting, diarrhea, and weight loss. CT abdomen pelvis showed evidence of diverticulitis. She was treated with antibiotics and discharged. Patient [...]