Case Report
Proximal Limb Weakness in a Patient with Celiac Disease: Copper Deficiency, Gluten Sensitivity, or Both as the Underlying Cause?
Table 1
Laboratory findings at diagnosis and after 1 month of TPN.
| | Parameter | Baseline | After 1 month of TPN | Normal range |
| | RBC (×1012/L) | 3.82 | 4.42 | 4.13–5.57 | | Hemoglobin (g/L) | 12.5 | 14.8 | 12.9–16.9 | | MCV (fL) | 102.3 | 99.3 | 82.6–97.4 | | WBC (×109/L) | 2.6 | 6.7 | 3.8–10.6 | | ANC (×109/L) | 0.5 | 2.1 | 1.5–7.7 | | Platelets (×109/L) | 369 | 293 | 156–369 | | Copper (µg/dL) | 6 | 93 | 60–190 | | Ceruloplasmin (mg/dL) | 3.1 | — | 22–58 | | Vitamin B12 (pg/mL) | 193 | 811 | 211–911 | | Zinc (µg/dL) | 0.72 | 0.78 | 0.55–1.5 | | Vitamin D (ng/mL) | 32 | — | 30–50 | | Vitamin E (µg/mL) | 8 | — | 5.5–17 | | Anti-gliadin Ab IgA (AU) | 165 | 137 | <20 | | Anti-gliadin Ab IgG (AU) | 39 | 35 | <20 | | Anti-TTG IgA (units) | 110 | 64 | <20 |
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TPN: total parenteral nutrition; RBC: red blood cells; MCV: mean corpuscular volume; WBC: white blood cells; ANC: absolute neutrophil count; Ab: antibody; AU: arbitrary units; TTG: tissue transglutaminase.
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