Copper and Protein Depletion Complicating Hypoferric Anemia of Infancy

Fourteen infants are described with a syndrome consisting of iron-deficiency anemia, hypocupremia and hypoproteinemia. Significant retardation of growth was noted in one-half of the patients. Evidence is presented to indicate that the hypocupremia is due to copper depletion and is not secondary to the hypoproteinemia. Abnormalities in the absorption and utilization of iron were not observed. Study of an additional 54 infants with iron deficiency anemia and normal or elevated levels of copper in the serum reveals a significant degree of growth retardation and hypoalbuminemia, both of which correlate well with the severity of the anemia. Hypotheses consistent with the results obtained are discussed. The possibility is proposed that initial severe deficiency of iron, resulting in marked anemia, led to protein depletion, and this in turn to impaired copper retention and consequent development of the complete syndrome.