Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States
Recently, drug shortages in the United States have affected multiple components of the parenteral nutrition (PN) solution. A 62-year-old patient with systemic sclerosis who was dependent on home PN due to intestinal dysmotility developed anemia and leukopenia approximately 4 months after parenteral...
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th-mahidol.323702018-10-19T12:41:57Z Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States Pornpoj Pramyothin Dong Wook Kim Lorraine S. Young Sanit Wichansawakun Caroline M. Apovian Boston University School of Medicine Mahidol University Thammasat University Medicine Nursing Recently, drug shortages in the United States have affected multiple components of the parenteral nutrition (PN) solution. A 62-year-old patient with systemic sclerosis who was dependent on home PN due to intestinal dysmotility developed anemia and leukopenia approximately 4 months after parenteral copper was withheld from her PN solution due to drug shortages. The patient was not able to tolerate a sufficient amount of oral multivitamins with trace elements due to severe dysphagia. Her serum copper and ceruloplasmin concentrations were undetectable, confirming the diagnosis of severe copper deficiency. The hematological abnormalities promptly resolved with copper supplementation. This report emphasizes the importance of close monitoring for nutrient deficiencies during drug shortages and supplementing with oral or enteral nutrition when feasible, particularly in high-risk patients such as those with intestinal malabsorption or short bowel syndrome who are dependent on long-term PN. © 2012 American Society for Parenteral and Enteral Nutrition. 2018-10-19T05:25:48Z 2018-10-19T05:25:48Z 2013-05-01 Article Journal of Parenteral and Enteral Nutrition. Vol.37, No.3 (2013), 425-429 10.1177/0148607112463942 01486071 2-s2.0-84876730766 https://repository.li.mahidol.ac.th/handle/123456789/32370 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84876730766&origin=inward |
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Medicine Nursing Pornpoj Pramyothin Dong Wook Kim Lorraine S. Young Sanit Wichansawakun Caroline M. Apovian Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States |
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Recently, drug shortages in the United States have affected multiple components of the parenteral nutrition (PN) solution. A 62-year-old patient with systemic sclerosis who was dependent on home PN due to intestinal dysmotility developed anemia and leukopenia approximately 4 months after parenteral copper was withheld from her PN solution due to drug shortages. The patient was not able to tolerate a sufficient amount of oral multivitamins with trace elements due to severe dysphagia. Her serum copper and ceruloplasmin concentrations were undetectable, confirming the diagnosis of severe copper deficiency. The hematological abnormalities promptly resolved with copper supplementation. This report emphasizes the importance of close monitoring for nutrient deficiencies during drug shortages and supplementing with oral or enteral nutrition when feasible, particularly in high-risk patients such as those with intestinal malabsorption or short bowel syndrome who are dependent on long-term PN. © 2012 American Society for Parenteral and Enteral Nutrition. |
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Boston University School of Medicine |
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Boston University School of Medicine Pornpoj Pramyothin Dong Wook Kim Lorraine S. Young Sanit Wichansawakun Caroline M. Apovian |
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Article |
author |
Pornpoj Pramyothin Dong Wook Kim Lorraine S. Young Sanit Wichansawakun Caroline M. Apovian |
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Pornpoj Pramyothin |
title |
Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States |
title_short |
Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States |
title_full |
Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States |
title_fullStr |
Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States |
title_full_unstemmed |
Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States |
title_sort |
anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the united states |
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2018 |
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https://repository.li.mahidol.ac.th/handle/123456789/32370 |
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1763491432418508800 |