A 3-year-old child from a low-income household has microcytic hypochromic anemia, poor wound healing, and perifollicular hemorrhages. Serum ferritin is normal. Which micronutrient deficiency best explains the full clinical picture?
- A Iron
- B Zinc
- C Copper ✓
- D Vitamin C (ascorbic acid)
Explanation
Copper deficiency causes a microcytic hypochromic anemia that mimics iron deficiency because ceruloplasmin (ferroxidase) is essential for oxidizing Fe2+ to Fe3+ for loading onto transferrin; without ceruloplasmin activity, iron cannot be mobilized from storage. Copper is also required for lysyl oxidase (collagen cross-linking, explaining poor wound healing), cytochrome c oxidase, and dopamine beta-hydroxylase. Perifollicular hemorrhages in a child with normal ferritin pointing away from iron deficiency and toward copper-related collagen dysfunction make copper deficiency the unifying diagnosis.
Reference: Harper's Illustrated Biochemistry, 32nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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