Department of Neurology, University of Michigan Health Systems, Ann Arbor, Michigan, USA.
Ann N Y Acad Sci. 2010 Jan;1184:173-87. doi: 10.1111/j.1749-6632.2009.05109.x.
Despite a long history, Wilson's disease, an autosomal recessive disease caused by mutations in the ATP7B gene, remains a commonly misdiagnosed import disease. Mutations in ATP7B result in abnormal copper metabolism and subsequent toxic accumulation of copper. Clinical manifestations of neurologic Wilson's disease include variable combinations of dysarthria, dystonia, tremor, and choreoathetosis. Among neurodegenerative diseases, it is unusual in that misdiagnosis and delay in treatment are clinically relevant because treatments can prevent and cure Wilson's disease, if they are given appropriately. If left untreated, Wilson's disease progresses to hepatic failure or severe neurologic disability and death, while those adequately treated have normal life spans. This review focuses on the neurologic features of Wilson's disease, its diagnosis, and treatment options.
尽管威尔逊病(Wilson's disease)已有很长的历史,这是一种常染色体隐性遗传病,由 ATP7B 基因突变引起,但它仍然是一种经常被误诊的输入性疾病。ATP7B 基因突变导致铜代谢异常,随后铜毒性蓄积。神经威尔逊病的临床表现包括构音障碍、肌张力障碍、震颤和舞蹈手足徐动症等多种组合。在神经退行性疾病中,这种疾病不同寻常的地方在于,误诊和治疗延误具有临床意义,因为如果给予适当的治疗,治疗可以预防和治愈威尔逊病。如果不治疗,威尔逊病会进展为肝衰竭或严重的神经功能障碍和死亡,而那些得到充分治疗的患者则具有正常的寿命。本综述重点介绍威尔逊病的神经特征、诊断和治疗选择。