Copper deficiency

[摘要] A 45 year-old woman presented for evaluation because of neutropeniaand anemia. Her complete blood counts (CBC) revealed Hb: 9 g/dl,MCV: 99 fl, WBC: 1.4 × 109/L, PLT: 257 × 109/L, and absoluteneutrophil count: 0.45 × 109/L. She was diagnosed with idiopathicautonomic neuropathy of the gastrointestinal tract since the age of 25years. On clinical examination, the patient was afebrile, but pale. Examination of a peripheral blood smear disclosed decreased granulationalong with abnormal nuclear globulization of the neutrophils (Figure1A) and cytoplasmic vacuolization of monocytes (Figure 1B).