Abstract
This is a case report of a person with severe motor and intellectual disabilities (SMID) who developed copper deficiency as a result of a change from one enteral diet to another, both of which meet the Japanese dietary intake standars (2005). This case is of a male patient who is suspected of having a spinocerebellar degeneration from family history. From December year x–6, feeding mode of the patient was changed from oral to tubal one due to functional decline. In April year x, the low residue diet was changed from E7® to CZ-Hi®. In December year x+1, leukopenia (1600/μl) and anemia (6.7g/dl) was noticed. The hematologists diagnosed these as aplastic anemia and treatment using anabolic steriod was started. In June year x-2, the serum copper level was 118μg/dl; however, in March year x+2, an abnormally low level of 4μg/dl was seen. Readministration of E7® diet with cocoa to enhance the copper content restored the serum copper level to normal range in approximately 2 months, and an improvement was seen in the hemogram. In this case study, there was no significant deficit in copper intake, nor was there excessive administration of zinc. Thus, the factors leading to copper deficiency could not be identified. Since there are many unknown factors regarding the complication mechanisms in patients with SMID, constant attention should be given to their nutrition and regular checkups should not be ignored.
