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Acquired and inherited copper deficiency
Medical expert of the article
Last reviewed: 04.07.2025
Approximately half of the copper consumed is absorbed. Copper that is absorbed in excess of metabolic needs is excreted in the bile. Copper is a component of many body proteins; almost all copper in the body is bound to proteins. Unbound (free) copper ions are toxic. Genetic mechanisms control the incorporation of copper into apoproteins and processes that prevent toxic accumulation of copper in the body.
Acquired copper deficiency
If the genetic mechanisms controlling copper metabolism are functioning normally, dietary deficiency rarely causes clinically significant copper deficiency. The only causes that have been reported are kwashiorkor, persistent diarrhea in infants (usually associated with a milk-only diet), severe malabsorption (as in sprue), and excessive zinc intake. Copper deficiency may cause neutropenia, impaired bone calcification, and a hypochromic anemia that is unresponsive to iron supplementation. Diagnosis is based on low serum copper and ceruloplasmin levels. Treatment of acquired copper deficiency is directed at the cause of the deficiency and copper supplementation at a dose of 1.5–3 mg/day orally (usually as copper sulfate).
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Hereditary copper deficiency
Hereditary copper deficiency (Menkes syndrome) occurs in newborn boys who inherit a mutant X-linked gene. The incidence is about 1 in 50,000 live births. Copper is decreased in the liver, serum, and copper-containing proteins: cytochrome C oxidase, ceruloplasmin, and lysyl oxidase. Symptoms include severe mental retardation; vomiting; diarrhea; protein-losing enteropathy; hypopigmentation; bone changes; ruptured arteries; sparse, coarse, curly hair. Diagnosis is based on low copper and ceruloplasmin levels, usually in infants less than 2 weeks of age. Typical treatment is parenteral copper (as copper sulfate) at a single dose of 20-30 mg/kg intravenously. However, parenterally administered copper is not metabolized by copper-containing enzymes. More effective may be the administration of copper-histidine complex at a dose of 100-600 mg subcutaneously once a day; constant monitoring is necessary during treatment.