Macrocytic anemia occurs in all except: (A) Thiamine deficiency, (B) Liver disease, (C) Orotic aciduria, (D) Copper deficiency
Answer is D. Copper - containing ceruloplasmin helps in iron transport. Copper is an integral part if ALA synthase enzyme which is used in haem synthesis.
Copper helps the uptake of iron by normoblasts. Thus in copper deficiency, RBC count is reduced, cell size is small but hemoglobin concentration is more or less normal.
So it results in microcytic normochromic anemia.