Hematogone hyperplasia in copper deficiency

Lisa Sutton, Madhuri Vusirikala, Weina Chen

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Copper deficiency is likely an underrecognized cause of anemia and neutropenia and may masquerade as a myelodysplastic syndrome (MDS). We report 2 cases of copper deficiency in which the diagnosis was suggested based on the characteristic morphologic findings, such as cytoplasmic vacuolization of erythroid and myeloid precursors and iron-containing plasma cells. It is interesting that both patients had hematogone hyperplasia. This phenomenon, largely absent in MDS, may aid in distinguishing nonclonal causes of cytopenias, such as copper deficiency, from MDS. It is of crucial importance to identify treatable causes of cytopenias when MDS is suspected. We recommend copper level assessment in patients suspected of having low-grade MDS, especially patients with neuropathy and normal results of cytogenetic studies.

Original languageEnglish (US)
Pages (from-to)191-199
Number of pages9
JournalAmerican journal of clinical pathology
Issue number2
StatePublished - Aug 2009


  • Copper deficiency
  • Cytoplasmic vacuoles
  • Hematogones
  • Iron-laden plasma cells
  • Zinc excess

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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