P. Papanastasiou

Poster 43: Effect of Intravenous Zoledronic Acid on Lumbar Spine Bone Mineral Density Compared to Oral Risedronate in Subgroups of Patients Receiving Glucocorticoid Therapy

2.89 K/mcL. Serum studies demonstrated normal levels of protein, albumin, B12, and folate. Serum copper was undetectable at that time. We developed a protocol to normalize serum copper levels. The protocol consisted of 2 mg copper sulfate infused over 2 hours 3 times a week for 2 weeks via a PICC line. Maintenance copper was administered daily via G-tube consisting of 10 mL copper chloride 0.4 mg/mL. Setting: State funded facility for mental retardation and physical disabilities. Results: Serum copper and complete blood count were followed every other week for a 4-month period. Serum copper responded immediately to copper infusion. The patient’s hemoglobin increased to 13.7 g/dL and WBC increased to 10.7 K/mcL. Discussion: This is the first documented case, to our knowledge, of copper deficiency anemia and leukopenia in a noncommunicative, physically disabled, and nutritionally dependent patient. Conclusions: Diagnosis of copper deficiency anemia and leukopenia requires a high degree of suspicion and identification of risk factors for diagnosis, but is completely reversible with copper supplementation.

Poster 42: Effect of a Single Intravenous Infusion of Zoledronic Acid on Bone Turnover Markers Compared to Oral Risedronate Over 1 Year in Patients with Glucocorticoid-Induced Osteoporosis

2.89 K/mcL. Serum studies demonstrated normal levels of protein, albumin, B12, and folate. Serum copper was undetectable at that time. We developed a protocol to normalize serum copper levels. The protocol consisted of 2 mg copper sulfate infused over 2 hours 3 times a week for 2 weeks via a PICC line. Maintenance copper was administered daily via G-tube consisting of 10 mL copper chloride 0.4 mg/mL. Setting: State funded facility for mental retardation and physical disabilities. Results: Serum copper and complete blood count were followed every other week for a 4-month period. Serum copper responded immediately to copper infusion. The patient’s hemoglobin increased to 13.7 g/dL and WBC increased to 10.7 K/mcL. Discussion: This is the first documented case, to our knowledge, of copper deficiency anemia and leukopenia in a noncommunicative, physically disabled, and nutritionally dependent patient. Conclusions: Diagnosis of copper deficiency anemia and leukopenia requires a high degree of suspicion and identification of risk factors for diagnosis, but is completely reversible with copper supplementation.