Copper Deficiency Anemia in Older Patients with Swallowing Disorders: A Case Report

BackgroundTrace element deficiency is most commonly a result of long-term intravenous nutrition; however, it can also develop on rare occasions in people who are fed orally. The present study aimed to investigate the development of copper-deficiency anemia in older patients who were provided with dysphagia diets because of swallowing disorders.MethodsThe study included 34 patients who were provided with dysphagia diet A for at least three months at Higashiyama Sanatorium for the Elderly in Kyoto, Japan.ResultsSix patients had hemoglobin levels below 10.0 g/dL before being placed on a dysphagia diet; however, this number increased to 17 during this study. Univariate analysis showed the factors associated with anemia onset to be serum copper level and dysphagia diet administration duration, whereas multivariate analysis showed only serum copper level to be significant. Receiver operating characteristic analysis showed the serum copper level cut-off value to be 13 mu g/dL with respect to development of anemia (sensitivity: 100%; specificity: 59%). In addition, oral copper supplementation for two months improved anemia in all 15 cases who were followed up.ConclusionsPatients receiving dysphagia diet are at risk of developing copper deficiency anemia. Copper supplementation is recommended for all older patients being prescribed this type of diet, and special attention is required in this respect.