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Acquired copper deficiency is an increasingly recognized cause of myeloneuropathy. Common causes of copper deficiency include a history of gastric surgery, malabsorption caused by gastrointestinal diseases, excess zinc ingestion, and parenteral nutrition without adequate copper supplementation. In many cases, the cause is not apparent.
The authors report a 69-year-old woman with a myeloneuropathy who had a 5-year history of gait unsteadiness and distal lower-extremity paresthesias and several years' history of unexplained weight loss and osteoporosis. Abnormal findings included a decreased serum copper level and markedly elevated gliadin and tissue transglutaminase antibodies. Nerve-conduction and electromyographic studies showed a mild, len…