Copper Deficiency and Polyneuropathy in the Critically Ill
A 38yo female with PMH of substance abuse presented in acute liver failure and new onset quadriparesis requiring ICU admission and mechanical ventilation. Physical examination demonstrated absent deep tendon reflexes and denervation of the upper extremities indicative of an acute inflammatory demyelinating polyneuropathy, which was unsuccessfully treated with IVIG. Further work up demonstrated a significantly low copper level. After treatment with IV copper, the patient had a rapid return of muscular tone, and was successfully extubated. We will discuss nutritional consequences of substance abuse and acute liver failure, as well as the consequences of low copper levels presenting as quadriparesis.
Aiello A, Daklallah Y, Asbahi M. Copper deficiency and polyneuropathy in the critically ill. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4980