|
|
|
|
The basic biochemical alteration responsible for deranged hepatobiliary copper homeostasis in Wilson's disease had yet to be identified.The gene for Wilson's disease has been mapped to chromosome 13,but the function of its gene produce has not yet been determined.The clinical manifestations of Wilson's disease are varied and often nonspecific and include a range of hepatic,neurologic,and psychiatric findings.Penicillamine remains the drug of choice for the treatment of Wilson's disease,but recent experience suggests that trientine and zinc may be safe,effective alternatives.All three drugs are probably safe for use in pregnant patients with Wilson's disease.Liver transplantation is the only effective treatment for Wilsonian fulminant hepatic failure and corrects the underlying metabolic defect.Conclusions:Wilson's disease is a disorder of hepatobiliary copper excretion manifested predominantly by hepatic and neurologic copper toxicosis and inherited in an autosomal recessive pattern.Although the specific underlying biochemical defect remains to be defined,specific therapy is available and usually successful.Maintaining a high index of suspicion is critical in diagnosing this readily treatable inherited disease. |
|