Polyneuropathy and Pancytopenia Secondary to Copper Deficiency

A 39-year-old woman came to our clinic reporting low back pain, which had become progressively worse during the past year. She also reported experiencing paresthesia in the distal lower extremities that moved proximally towards her waist over the preceding 6 months as well as some tingling numbness in the hand and diminished clarity of vision during the past 2 months. The patient denied any changes in mental activity, motor deficits, and sensory ataxia. She experienced some urinary urgency at night but not during the day.