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wilson_disease [2025/02/18 03:49] Scott Larsonwilson_disease [2025/04/18 20:40] (current) – external edit 127.0.0.1
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   * Hepatic disease due to excess accumulation of copper   * Hepatic disease due to excess accumulation of copper
   * Neurologic impairment from copper overload   * Neurologic impairment from copper overload
-  * Laboratory findings are low serum ceruloplasmin and high 24 hour urinary copper excretion +  * Laboratory findings 
 +    * Low serum ceruloplasmin levels <14 mg/dl 
 +    * 24 hour urine copper excretion >40 μg 
 +  * Treatment involves reducing copper concentrations with penicallamine or Tridentine and liver transplant 
  
 ====Eye Findings==== ====Eye Findings====
   * Kayser-Fleischer rings   * Kayser-Fleischer rings
     * copper deposition in Descemet's membrane      * copper deposition in Descemet's membrane 
-    * present in about 50% in those with hepatic disease+    * present in about 50% in those with hepatic disease  
 +    * {{::kayser-fleischer_ring.jpg|}} from [[https://en.wikipedia.org/wiki/Kayser–Fleischer_ring#/media/File:Kayser-Fleischer_ring.jpg|https://en.wikipedia.org/wiki/Kayser–Fleischer_ring#/media/File:Kayser-Fleischer_ring.jpg]]
   * Sunflower Cataracts- radiating multicolored central opacities, less common    * Sunflower Cataracts- radiating multicolored central opacities, less common 
 +  * {{::kf_ring_and_sunflower_cataract.jpg|}} from [[https://en.wikipedia.org/wiki/Kayser–Fleischer_ring#/media/File:KF_ring_and_Sunflower_cataract.jpg|https://en.wikipedia.org/wiki/Kayser–Fleischer_ring#/media/File:KF_ring_and_Sunflower_cataract.jpg]]
 +  * Possible mild retinal neurodegeneration
 +    * thinning of the retinal nerve fiber layer
 +    * delayed VEPs
 +  * Gaze palsy, especially up gaze
 ====Other Findings==== ====Other Findings====
 {{::wilson_disease_manifestations.jpg|}} {{::wilson_disease_manifestations.jpg|}}
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   * Autosomal recessive disorder of copper metabolism from mutations in the ATP7B gene leading to impaired copper secretion    * Autosomal recessive disorder of copper metabolism from mutations in the ATP7B gene leading to impaired copper secretion 
   * ATP7B encodes for a copper-transporting ATPase   * ATP7B encodes for a copper-transporting ATPase
 +  * 1:40,000 to 1:50,000 
 ====Reference==== ====Reference====
-  * [[link|Title]]+  * {{::wilson_disease-_copper-mediated_cuproptosis_iron-related_ferroptosis_and_clinical_highlights_with_comprehensive_and_critical_analysis_update.pdf |Teschke R. et al. Wilson Disease: Copper-Mediated Cuproptosis, Iron-Related 
 +Ferroptosis, and Clinical Highlights, with Comprehensive and Critical Analysis Update. Int.J.Mol.Sci.2024;25:4753}} 
 +  * [[https://en.wikipedia.org/wiki/Kayser–Fleischer_ring|Wikipedia:Kayser-Fleisher ring]] 
 +  * [[https://pubmed.ncbi.nlm.nih.gov/23166778/|Albrecht et al. Retinal neurodegeneration in Wilson's disease revealed by spectral domain optical coherence tomography. PLoS One 2012;7(11):e49825]]
  
 {{tag>syndrome}} {{tag>syndrome}}