Risk factors:
(1) prematurity
(2) prolonged intravenous alimentation
(3) malnutrition/kwashiorkor
(4) persistent vomiting with inadequate diet
(5) exclusive copper-deficient milk diet
Clinical findings:
(1) failure to thrive
(2) apathy
(3) hypotonia
(4) hypothermia
(5) psychomotor retardation
(6) visual impairment
(7) underpigmented hair and skin
(8) osteoporosis with metaphyseal flaring, cupping and spurs
(9) seborrheic dermatitis
(10) distended blood vessels
Laboratory findings:
(1) anemia unresponsive to iron, folate or vitamin B12
(2) leukopenia with neutropenia
(3) sideroblasts in the bone marrow with vacuolated myeloid and erythroid precursor cells
(4) low serum ceruloplasmin
(5) low serum copper concentration
