401
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Giannini E, Fasoli A, Botta F, Testa R. Wilson's disease with concomitant beta thalassaemia and factor V deficiency. ITALIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 1998; 30:633-5. [PMID: 10076789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A case of late presentation of Wilson's disease in a female with a thalassaemic trait is reported in whom diagnosis of Factor V deficiency was made. Despite ignoring the disease for years the patient had compensated cirrhosis. She had a dramatic family history of Wilson's disease affecting at least two brothers and two sisters. Moreover, her haematologic problems were not clinically revealed until diagnosis had been made on the basis of suspicions arising from laboratory results. The therapy of choice for hepatolenticular degeneration was not feasible due to the patient's refusal. Zinc salts were, therefore, administered. To our knowledge the association of such rare genetic disorders has not been reported.
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402
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Lee JJ, Kim HJ, Chung IJ, Kook H, Byun JR, Kwon SY, Park MR, Choi KS, Hwang TJ, Ryang DW. Acute hemolytic crisis with fulminant hepatic failure as the first manifestation of Wilson's disease: a case report. J Korean Med Sci 1998; 13:548-50. [PMID: 9811188 PMCID: PMC3054522 DOI: 10.3346/jkms.1998.13.5.548] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We report a 27-year-old woman who developed Coombs' negative hemolytic anemia and fulminant hepatic failure as the initial manifestation of Wilson's disease. Unmeasurably low level of serum alkaline phosphatase provided a clue to the diagnosis of Wilson's disease. The diagnosis was established with the presence of Kayser-Fleischer ring, decreased serum ceruloplasmin level, and elevated urine and serum copper levels. In spite of repeated plasmapheresis, she died of multiorgan failure on the fifth hospital day.
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403
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Mainardi JL, Figliolini C, Goldstein FW, Blanche P, Baret-Rigoulet M, Galezowski N, Fournier PE, Raoult D. Cat scratch disease due to Bartonella henselae serotype Marseille (Swiss cat) in a seronegative patient. J Clin Microbiol 1998; 36:2800. [PMID: 9742017 PMCID: PMC105217 DOI: 10.1128/jcm.36.9.2800-2800.1998] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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404
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Donfrid M, Jankovic G, Strahinja R, Colovic R, Begic-Janeva A, Colovic M. Idiopathic thrombocytopenia associated with Wilson's disease. HEPATO-GASTROENTEROLOGY 1998; 45:1774-6. [PMID: 9840146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We present the case of a 53 year-old patient with idiopathic thrombocytopenia associated with Wilson's disease. Idiopathic thrombocytopenia was diagnosed in August of 1994, and as the response to corticosteroid therapy was poor, the patient underwent a splenectomy in October of the same year. A liver biopsy, which was performed during the operation, showed Wilson's disease in the form of mild, chronic, active hepatitis. The serum ceruloplasmin was low, and the Kayser Fleischer's ring was positive. MRI of the brain showed cortical reductive changes with areas of copper accumulation in the white brain matter. An unusual presentation of Wilson's disease associated with idiopathic thrombocytopenia has not been published as of yet. The diagnosis of Wilson's disease was made at an advanced, adult age, which may implicate a heterozygous genetic configuration.
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405
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Kawahara S, Morimoto K, Nakazawa H, Kumagai T, Saito T, Aikawa S, Tsuboi I, Sawada U, Horie T. [Severe hemolytic anemia with tear drop red cells as initial manifestation of Wilson's disease]. [RINSHO KETSUEKI] THE JAPANESE JOURNAL OF CLINICAL HEMATOLOGY 1998; 39:665-9. [PMID: 9796400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A 16-year-old girl was admitted for a detailed examination of hemolytic anemia in November 1995. Initial laboratory findings included a total bilirubin concentration of 1.46 mg/dl, hemoglobin of 9.1 g/dl, and a reticulocyte count of 89/1000 percent. The plasma haptoglobin concentration was below 10 mg/dl. A blood smear showed many dacryocytes and a few echinocytes and codocytes. GOT was 71 IU/l; GPT, 44 IU/l; and LDH, 812 IU/l; the results of a hepaplastin test were 45% of normal. On further investigation, the level of serum ceruloplasmin was found to be 4 mg/dl, and of serum copper, 43 micrograms/dl. Urinary copper excretion was markedly increased, at 345 micrograms per day. Slit-lamp examination of both corneas revealed obvious Kayser-Fleischer rings. A liver biopsy sample showed fibrosis histologically and an elevated copper concentration of 535 micrograms/g dry weight and 183 micrograms/g wet weight. In family studies, the patient's asymptomatic 5-year-old sister was observed to have metabolic abnormalities consistent with Wilson's disease. These findings suggested that the patient's hemolytic anemia with red cell deformities was due to abnormal copper metabolism associated with Wilson's disease.
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406
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Bax RT, Hässler A, Luck W, Hefter H, Krägeloh-Mann I, Neuhaus P, Emmrich P. Cerebral manifestation of Wilson's disease successfully treated with liver transplantation. Neurology 1998; 51:863-5. [PMID: 9748041 DOI: 10.1212/wnl.51.3.863] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The main indication for orthotopic liver transplantation (OLTx) in Wilson's disease (WD) is severe hepatic decompensation. Our 15-year-old patient is the second case to date in whom OLTx was performed because of neurologic manifestations resulting from WD. His initial condition involving recurrent headaches, tremor, and athetoid hand movements progressively deteriorated during therapy with D-penicillamine, zinc sulfate, and trientine until he was severely dysarthric, unable to walk, and bedridden. After OLTx, his neurologic condition became almost normal.
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407
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Mustafa MS, Shamina AH. Five successful deliveries following 9 consecutive spontaneous abortions in a patient with Wilson disease. Aust N Z J Obstet Gynaecol 1998; 38:312-4. [PMID: 9761160 DOI: 10.1111/j.1479-828x.1998.tb03073.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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408
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409
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Okada M, Higashi K, Enomoto S, Fujii Y, Yamane H, Tsujiuti K, Tanimoto S, Itoh H, Nishioka S, Yasui M, Tanaka T. [A case of Wilson's disease associated with hypoparathyroidism and amenorrhea]. NIHON SHOKAKIBYO GAKKAI ZASSHI = THE JAPANESE JOURNAL OF GASTRO-ENTEROLOGY 1998; 95:445-9. [PMID: 9621702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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410
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Neretin VI, Kotov SV. [Tremor as a symptom of organic brain damage in individuals of young age]. Zh Nevrol Psikhiatr Im S S Korsakova 1998; 98:9-12. [PMID: 9532710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cases of young patients with different diseases of nervous system in which tremor was the main symptom, clinical peculiarities of trembling hyperkinesis in essential tremor, in olivopontocerebellar degeneration, in strionigral atrophia, in residual phenomena of organic brain damages as well as their differences from functional hyperkinesia are characterized. The data are presented on comparative efficiency of different methods of examination.
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411
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Möhler M, Wagner V, Stremmel W. [Hereditary liver diseases. Recent molecular genetic aspects]. Dtsch Med Wochenschr 1998; 123:466-71. [PMID: 9581163 DOI: 10.1055/s-2007-1023997] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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412
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Abstract
Selection of a method of contraception in patients with liver disease can be complicated. Tubal ligation should be considered in the setting of chronic liver disease for those patients who have completed families. Multiple reversible methods of contraception are currently available but may affect hepatic disease. Estrogen-containing contraceptive methods are contraindicated in patients with acute liver disease. Progestin contraceptives appear to be safe and multiple delivery systems are available. With rare exception, barrier methods and the intrauterine device may be offered as alternative methods.
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413
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Abstract
BACKGROUND Patients who present with fulminant hepatic failure due to Wilson's disease may develop hemolytic anemia and renal insufficiency. In this entity, acute hepatocellular necrosis triggers the release of copper ions into the circulation, which leads to toxic effects on red cell metabolic pathways and hemolysis. STUDY DESIGN AND METHODS The utility of therapeutic plasma exchange to rapidly remove copper and reduce toxic serum copper levels was studied in two patients with fulminant Wilson's disease. RESULTS Intensive plasma exchange using fresh-frozen plasma replacement removed substantial amounts of copper from the hypercupremic patients, resulting in a rapid reduction in serum copper levels and decreased hemolysis. The net copper removal was proportional to the serum level, ranging from 7,000 to 11,800 micrograms per procedure in one patient and from 3,700 to 6,800 micrograms in the other. CONCLUSION Plasma exchange allows a rapid reduction in elevated serum copper levels in patients with fulminant Wilson's disease. This leads to an amelioration of hemolytic anemia and provides clinical stabilization until liver transplantation can be performed.
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414
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Martínez-Frías ML, Rodríguez-Pinilla E, Bermejo E, Blanco M. Prenatal exposure to penicillamine and oral clefts: case report. AMERICAN JOURNAL OF MEDICAL GENETICS 1998; 76:274-5. [PMID: 9508249 DOI: 10.1002/(sici)1096-8628(19980319)76:3<274::aid-ajmg13>3.0.co;2-e] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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415
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Feist D. ["Alcoholic" liver damage in nonalcoholics: nonalcoholic steatohepatitis]. Dtsch Med Wochenschr 1998; 123:237. [PMID: 9526494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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416
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Angius A, Dessi V, Lovicu M, De Virgiliis S, Pirastu M, Cao A. Early and severe neurological features in a Wilson disease patient compound heterozygous for two frameshift mutations. Eur J Pediatr 1998; 157:128-9. [PMID: 9504786 DOI: 10.1007/s004310050783] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED We describe a patient with Wilson disease who presented at 11 years of age with neurological symptoms and subsequent rapid progression of neurological impairment but absent hepatic manifestations. Molecular analysis showed compound heterozygosity for two frameshift mutations, 2299insC and 214delAT, which most likely result in an absent or inactive protein product. Mutation-phenotypic analysis indicates that this genotype does not explain the severe phenotype, suggesting the presence of modifying factors. CONCLUSION Wilson disease may present even in childhood or adolescence with neurological abnormalities in the absence of hepatic manifestations.
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417
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Matsuura T, Sasaki H, Tashiro K. Atypical MR findings in Wilson's disease: pronounced lesions in the dentate nucleus causing tremor. J Neurol Neurosurg Psychiatry 1998; 64:161. [PMID: 9489523 PMCID: PMC2169957 DOI: 10.1136/jnnp.64.2.161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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418
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Abstract
Liver replacement provides an effective method of replacing a failing liver, and corrects the underlying defect in many metabolic conditions. Results of liver transplantation for metabolic diseases have been encouraging, with the exception of hereditary hemochromatosis, in which infectious and for which cardiac complications appear to increase posttransplant mortality. An improved understanding of the underlying genetic and molecular defect will lead to advances in medical therapy and perhaps will decrease the need for liver replacement. The prospects of gene therapy are being pursued for many metabolic disorders, however until this research leads to direct clinical application, liver transplantation remains the only effective option for many patients with metabolic liver disease.
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419
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420
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Troncoso M, Badilla L, Bravo E, Miranda M, Gajewski C, Barrios A, Villagra R. [Neuroradiological findings in 2 cases of Wilson disease with neurological involvement]. Rev Med Chil 1998; 126:81-7. [PMID: 9629758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Wilson disease is an inborn error of copper metabolism that has neurological and hepatic manifestations. We report a 13 years old girl and a 12 years old boy with Wilson disease. In both patient, brain computed tomography and magnetic resonance imaging showed marked involvement of basal ganglia and other deep gray nuclei. Considering that this is a treatable disease, it should be included in the differential diagnosis of the so called "striatal necrosis of childhood".
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421
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Abstract
MR imaging examinations of seven patients with a variety of claustral disorders are included in this study. The ages of the patients ranged from 4 to 65 years, and all of them were males. The lesions involving the claustrum comprised cases with asphyxia, Wilson's disease, ischemic white matter disease, thalamic arteriovenous malformation, MELAS syndrome, viral encephalitis and Parkinson's disease.
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422
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Jabłońska J, Popow J, Rodo M, Członkowska A. [Liver failure in the course of Wilson's disease--report of two cases]. POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ 1997; 98:542-5. [PMID: 9640083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Wilson's disease is an autosomal recessive disorder characterized by inability to excrete copper, and manifests by hepatic, neurologic or/and psychiatric symptoms. The therapy is available if diagnosis is made in time. The hepatic form of the disease is rarely recognized in Poland. The authors describe two patients with Wilson's disease who developed acute hepatic failure leading to death, in the first case within few months, in the second within few weeks. The diagnosis was established in the terminal stage of the disease and attempts of treatment were uneffective.
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423
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Shah N, Kumar D. Wilson's disease, psychosis, and ECT. CONVULSIVE THERAPY 1997; 13:278-9. [PMID: 9437572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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424
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425
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Haimov-Kochman R, Ackerman Z, Anteby EY. The contraceptive choice for a Wilson's disease patient with chronic liver disease. Contraception 1997; 56:241-4. [PMID: 9408705 DOI: 10.1016/s0010-7824(97)00141-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Preserved fertility status is frequently encountered in patients with Wilson's disease, and contraceptive counseling may, therefore, be a relevant issue. Yet, several contraceptive methods can adversely influence the hepatic function, and the efficacy of others may be affected by the liver disease. We describe a patient with Wilson's disease manifested by cirrhosis, portal hypertension, and bleeding esophageal varices who underwent termination of pregnancy at 9 weeks' gestation. Following the procedure, contraceptive advice was sought in order to postpone conception until portal hypertension was controlled and hepatic function improved. Intramuscular depot medroxyprogesterone acetate was administered and tolerated well by the patient. A detailed discussion of the contraceptive options for patients with chronic liver disease, in general, and Wilson's disease, in particular, follows the case report.
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