Wilson's disease - clinical picture, factors influencing disease progression, treatment methods
DOI:
https://doi.org/10.12775/QS.2024.15.51826Keywords
Wilson's disease, Kayser-Fleischer ring, ceruloplasmin, copper metabolismAbstract
Wilson's disease, also known as hepatolenticular degeneration, is a rare genetic metabolic disorder that leads to excessive accumulation of copper in the body, particularly in the liver and brain. This results in the gradual damage of these organs and leads to a variety of clinical symptoms. The symptoms of Wilson's disease can be diverse, leading to a broad spectrum of clinical manifestations including fatigue, jaundice, hand tremors, mood disorders, difficulty walking, speech disturbances, as well as neurological and psychiatric issues.The treatment of Wilson's disease typically involves the oral administration of copper-chelating agents, which help the body to eliminate the excess copper. In some cases, symptomatic treatment related to liver or brain damage may also be necessary. The diagnosis of Wilson's disease is based on laboratory tests, imaging studies (such as MRI or CT scans), and the assessment of clinical symptoms. Due to the variety of symptoms, patients are often misdiagnosed, and untreated Wilson's disease inevitably leads to death. Genetic testing can also be useful in confirming the diagnosis. Although Wilson's disease is a chronic condition, with appropriate treatment and monitoring, its symptoms can be effectively managed, and further damage to the liver and brain can be prevented. Regular monitoring of copper levels in the blood, as well as liver and brain function, is crucial for the effective management of Wilson's disease.
References
(1) Mulligan C, Bronstein JM. Wilson Disease: An Overview and Approach to Management. Neurol Clin. 2020 May;38(2):417-432. doi: 10.1016/j.ncl.2020.01.005. Epub 2020 Feb 28. PMID: 32279718
(2) Kelly C, Pericleous M. Wilson disease: more than meets the eye. Postgrad Med J. 2018 Jun;94(1112):335-347. doi: 10.1136/postgradmedj-2017-135381. Epub 2018 Feb 15. PMID: 29449431
(3) Hoogenraad T. Wilson’s Disease. Major Problems in neurology. W.B. Saunders Company Ltd, London 1996.
(4) Fernando M, van Mourik I, Wassmer E, kelly D. Wilson disease in children and adolescents. Arch Dis Child. 2020 May;105(5):499-505. doi: 10.1136/archdischild-2018-313705. Epub 2020 Jan 23. PMID: 31974298.
(5) Członkowska A, Litwin T, Dusek P, Ferenci P, Lutsenko S, Medici V, Rybakowski JK, Weiss KH, Schilsky ML. Wilson disease. Nat Rev Dis Primers. 2018 Sep 6;4(1):21 doi: 10.1038/s41572-018-0018-3. PMID:30190489; PMCID: PMC6416051
(6) Schilsky ML. Wilson disease: Diagnosis, Treatment, and Follow-up. Clin Liver Dis. 2017 Nov;21(4):755-767. doi: 10.1016/j.cld.2017.06.011. Epub 2017 Aug10.PMID 28987261
(7) Guindi M. Wilson disease. Semin Diagn Pathol. 2019 Nov;36(6):415-422. doi: 10.1053/j.semdp.2019.07.008.Epub 2019 Jul 25. PMID: 31421978
(8) Thomas G., Forbes J., Roberts E., Walsche J. i wsp. The Wilson’s Disease gene; Spectrum of mutations and their consequences. Nature Genetics 9 1995; 210.
(9) Bayersdorff A, Findeisen A: Morbus Wilson: case report of two year old child as first manifestation. Scan J gastroenterol 2006; 41: 496-497.
(10) Ferenci P, Członkowska A, Merle U et al.: Late-onset Wilson’s disease. gastroenterology 2007; 132: 1294-1298.
(11) Ala A, Borjigin J, Rochwarger A, Schilsky M: Wilson disease in septuagenarian siblings: raising the bar for diagnosis. hepatology 2005; 41: 668-670.
(12) Pfeiffer R: Wilson’s disease. Semin Neurol 2007; 27: 123-132.
(13) Roberts e, Schilsky M: Diagnosis and treatment of Wilson’s disease an update. hepatology 2008; 47: 2089-2111.
(14) Walshe JM, yealland M: Wilson’s disease: the problem of delayed diagnosis. J Neurol Neurosurg Psychiatry 1992; 55:692-696.
(15) Oder W, grimm g, Kollegger h et al.: Neurological and neuropsychiatric spectrum of Wilson’s disease: a prospective study of 45 cases. J Neurol 1991; 238: 281-287.
(16) Seniów J, Bak T, gajda J et al.: Cognitive funtionining In neu- rologically symptomatic and asymptomatic forms of Wilson’s disease. Mov Disord 2002; 17: 1077-1083.
(17) Medici V, Trevisan CP, D’Inca R et al.: Diagnosis and mana- gement of Wilson’s disease: results of a single center expe- rience. J Clin gastroenterol 2006; 40: 936-941.
(18) Golding DN, Walshe JM: Arthropathy of Wilson’s disease: study of clinical and radiological features in 32 patients. Ann Rheum Dis 1977; 36: 99-111.
(19) Canelas hM, Carvalho N, Scaff M et al: osteoarthropathy of hepatolenticular degeneration. Acta Neurol Scand 1978; 57: 481-487.
(20) Wiebers Do, Wilson DM, McLeod RA, goldstein NP: Renal stones in Wilson’s disease. Am J Med 1979; 67: 259-254.
(21) Leu ML, Strickland gT, Wang CC, Chen TS: Skin pigmentation in Wilson disease. JAMA 1970; 211: 1542-1543.
(22) Yarze JC, Martin P, Munoz SJ, Friedman LS: Wilson’s disease: current status. Am J Med 1992; 92: 643-654.
(23) Pfeiffer R. Wilson’s disease. Semin Neurol 2007; 27: 123-132.
(24) Roberts E., Schilsky M. Diagnosis and treatment of Wilson’s disease an update. Hepatology 2008; 47: 2089-2111.
(25) Litwin T., Gromadzka G., Czlonkowska A. Gender differences in Wilson’s disease. J Neurol Sci 2012; 312: 31-35.
(26) Gromadzka G., Czlonkowska A. Influence of IL-1RN intron 2 variable number of tandem repeats (VNTR) polymorphism on the age at onset of neuropsychiatric symptoms in Wilson’s disease. Int J Neurosci 2011; 121: 8-15.
(27) Rigamonti C., Andorno S., Maduli E. i wsp. Gender and liver fibrosis in chronic hepatitis: the role of iron status. Aliment Phar- macol Ther 2005; 21: 1445-1451.
(28) Schwimmer J., McGreal N., Deutsch R. i wsp. Influence of gender, race and ethnicity on suspected fatty liver obese adoles- cents. Pediatrics 2005; 115: 561-565.
(29) Bruha R., Vitek L., Marecek Z. i wsp. Decreased serum antiox- idant capacity in patients with Wilson disease is associated with neurological symptoms. J Inherit Metab Dis 2012; 35: 541-548.
(30) Rodo M., Cz3onkowska A., Pulawska M. i wsp. The level of se- rum lipids, vitamin E and low density lipoprotein oxidation in Wilson’s disease patients. Eur J Neurol 2000; 7: 491-494.
(31) Anderson L., Hakojarvi S., Boudreaux S. Zinc acetate treatment in Wil- son’s disease. Ann. Pharmacother. 1998; 32: 78–87.
(32) Masełbas W, Czlonkowska A, Litwin T, Niewada M. Persistence with treatment for Wilson disease: a retrospective study. BMC Neurology 2019; 19: 278.
(33) Czlonkowska A, Litwin T, Dusek P, Ferenci P, Lutsenko S, Medici V et al. Wilson Disease. Nat Rev Dis Primers 2018; 4(1): 21.
(34) Pujol M, Cuillel M, Renaudet O, Lebrun C, Charbonnier P, Cassio D et al. Hepatocyte targeting and intracellular copper chelation by a thiol-containing glycocyclopeptide. J Am Chem Soc 2011; 133: 286-296.
(35) Park SM, Vo K, Lallier M, Cloutier AS, Brochu P, Alvarez F, et al. Hepatocyte transplantation in the Long Evans Cinnamon rat model of Wilson’s disease. Cell Transplantation 2006; 15: 13-22.
(36) Sauer V, Siaj R, Stöppeler S, Bahde R, Spiegel HU, Köhler G et al. Repeated transplantation of hepatocytes prevents fulminant hepatitis in a rat model of Wilson’s disease. Liver Trnsplantation 2012; 18: 248-259.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Monika Korga, Paweł Pawlik, Przemysław Zaroda, Jakub Wawrzkowicz, Patrycja Niewinna, Paweł Dąda, Dominika Mańdziuk , Michał Żuchowski, Klaudia Kołodziej , Wojciech Kołodziej

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 192
Number of citations: 0