Copper, zinc, and iron levels in myelodysplastic syndrome patients versus healthy subject

Introduction: Myelodysplastic syndrome (MDS) is a heterogeneous group of disorders characterized by peripheral cytopenias despite increased hematopoietic precursors (ineffectiveerythropoiesis). Myelodysplastic morphology of blood cells can be encountered not only in myelodysplastic syndrome but also in nonclonal disorders like infections, autoimmunedisorders, iron deficiency anemia, megaloblastic anemia, copper deficiency and etc. Copper deficiency is likely an underrecognized cause of anemia and neutropenia and could bemisdiagnosed as a myelodysplastic syndrome (MDS) andCopper deficiency itself could induce dysplastic changes and iron overload. Some references such as Up to Date havesuggested that measurement of serum copper level should be performed as a diagnostic test for myelodysplastic syndrome but some other references such as williams ,didn’t mention that. So we decided to study the evaluation of serum iron, copper and zinc in patients with myelodysplastic symdrome in Bahonar hospital of Kerman(Iran) in 2016 to 2018.Method: 31 patients entered the study based on entry criteria .Serum Copper, iron,zinc , ceruloplasmin level were established , and bone marrow iron storages were evaluated basedon the results of bone marrow biopsies in 31 MDS patients. And we aslo selected the same control group with patient group and we measured their serum copper levels and thencompared them with patients. Results: 5 of 31 MDS patients were copper deficient(16.13%) Which was significant in comparison with the control group(p=0.02) .Mean serum copper level in patients with MDS was significantly lower than non-patients(p=0.0001)and Copper deficiency in these 5 patients was significantly associated with an increase in serum iron levels(0.001) but There was no significant difference in bone marrow Iron storage between patients with and without copper deficiency(p=0.2)and also no significant difference serum zinc between patients with and without copper deficiency . Conclusion: Copper deficiency is a frequent finding in MDS.It is desirable to include copperlevel determination in the initial workup of MDS.

Keywords:

serum iron , copper and zinc , myelodysplastic syndrome , ineffective erythropoiesis