Wilson Disease
by
Laurie Rosenblum, MPH DefinitionWilson disease causes a build up of copper in the body. It is very rare. Too much copper can be poisonous. Copper is a mineral we get from food. Our bodies need it in small amounts. We eat much more copper than we need. The copper needs to be passed out of our bodies. People with Wilson disease cannot pass the copper they do not need. The copper builds up in the body and damages organs like the liver, brain, kidneys, and eyes. This disease is fatal unless it is treated before serious illness develops.
CausesWilson disease is a genetic disorder. A faulty gene causes this system to malfunction. Both parents must have the faulty gene in order for the child to develop the disease. People with only one faulty gene may never have symptoms. However, they can pass the gene on to their children. Risk Factors TOPThe only known factor that increases your risk for Wilson disease is a family history of the disease. It tends to be most common in eastern Europeans, Sicilians, and southern Italians. Symptoms TOPIt may take some time for copper to build up. At first, the liver will hold the excess copper. Eventually, the liver will not be able to hold the copper. Copper will begin to leave the liver and move to other organs like the brain or eyes. Symptoms most commonly appear in people under 40 years old. In children, the symptoms can be present as early as five years of age.
Diagnosis TOPWilson disease is rare. Symptoms may be attributed to other more common causes like hepatitis or cirrhosis. You may also appear healthy even while your liver is getting damaged. However, it is important to get diagnosed and treated early. This will help to avoid organ damage and early death. Your doctor will ask about your symptoms and medical history. A physical and mental exam will be done. Your eyes will be examined for brown, ring-shaped color in the cornea (Kayser-Fleischer rings). Your bodily fluids and tissues may be tested for copper. This can be done with:
Images may be taken of your brain. This can be done with MRI. Genetic TestingYou may consider genetic testing if there is a family history of Wilson disease. If the condition is identified before symptoms develop, it may prevent serious complications. It may also be recommended in people who don't have a history of high alcohol intake but have a fatty liver. Genetic counseling may be helpful to review risks of genetic testing. Treatment TOPThe goals of treatment are to:
Treatment cannot cure the underlying problem of copper build up. You will need to continue treatment throughout your lifetime. MedicationsMedications may help by:
Dietary ChangesCertain changes in your diet may help reduce your copper intake:
Liver TransplantA liver transplant may be needed if you have severe liver damage. Transplantation may also be needed if you can not tolerate the side effects of medications. Prevention TOPCurrently, there are no guidelines to prevent Wilson disease. RESOURCES:American Association for the Study of Liver Diseases https://www.aasld.org Wilson Disease Association http://www.wilsonsdisease.org References:
About Wilson Disease. Wilson Disease Association website. Available at:
http://www.wilsonsdisease.org/about-wilsondisease.php
. Accessed April 26, 2013.
Brewer GJ, Askari F, Lorincz MT, Carlson M, Schilsky M, Kluin KJ, et al.
Treatment of Wilson disease with ammonium tetrathiomolybdate: IV. Comparison of tetrathiomolybdate and trientine in a double-blind study of treatment of the neurologic presentation of Wilson disease.
Arch Neurol
. 2006 Apr;63(4):521-7.
Ferenci P. Wilson disease.
Clin Gastroenterol Hepatol
. 2005 Aug;3(8):726-33.
Wilson disease. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php
. Updated April 8, 2013. Accessed April 26, 2013.
Wilson Disease. National Digestive Disease Information Clearinghouse website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/wilson/
. Updated April 30, 2012. Accessed April 26, 2013.
Last reviewed April 2013 by Michael Woods, MD Last Updated: 4/26/2013 | |