Spinal Cord Subacute Combined Degeneration Mimicked by Copper Deficiency: A Case Report

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL Clinical Case Reports Pub Date : 2025-02-07 DOI:10.1002/ccr3.70190

Zekarias Seifu Ayalew, Mehariw Wondimu Netsere, Matyas Adugna Abebe, Surafel Tilahun Maru, Gebeyehu Tessema Azibte, Aynalem Demsis Biza, Getnet Yigzaw Mossie

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Abstract

This case report underscores the diagnostic challenge of copper-deficiency myelopathy (CDM) and subacute combined degeneration (SCD) due to their similar clinical presentations. A 32-year-old male farmer initially treated for SCD with normal vitamin B12 levels showed no improvement, leading to a delayed diagnosis of CDM. His symptoms included sensory ataxia, spasticity, and sensory loss in the lower extremities, which resolved with oral copper supplementation. Clinicians should maintain a high index of suspicion for CDM, especially in patients who are unresponsive to B12 therapy. This case also highlights that marginal copper deficiency can cause significant neurological symptoms and that early intervention with copper supplementation can lead to full recovery, preventing irreversible damage. It also emphasizes the need for comprehensive testing, including copper levels, in cases of atypical myelopathy to avoid a delayed diagnosis.

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铜缺乏引起的脊髓亚急性合并变性1例报告

本病例报告强调了缺铜脊髓病（CDM）和亚急性合并变性（SCD）的诊断挑战，因为它们的临床表现相似。一名32岁男性农民最初接受SCD治疗，维生素B12水平正常，但没有改善，导致CDM诊断延迟。他的症状包括感觉共济失调、痉挛和下肢感觉丧失，这些症状在口服补铜后得到缓解。临床医生应保持对CDM的高度怀疑，特别是对B12治疗无反应的患者。该病例还强调，轻度缺铜可引起严重的神经系统症状，早期干预补充铜可导致完全恢复，防止不可逆转的损害。它还强调，在非典型脊髓病病例中，需要进行包括铜水平在内的全面检测，以避免延误诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Case Reports MEDICINE, GENERAL & INTERNAL-

自引率

14.30%

发文量

1268

审稿时长

13 weeks

期刊介绍： Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).