Glass J D, Reich S G, DeLong M R
Department of Neurology, Johns Hopkins Hospital, Baltimore, Md 21205.
Arch Neurol. 1990 May;47(5):595-6. doi: 10.1001/archneur.1990.00530050119022.
Patients with neurological symptoms and signs of Wilson's disease have been frequently noted to have a worsening of their condition after beginning chelation therapy with D-penicillamine. Presymptomatic patients, however, are not expected to develop neurological manifestations once appropriate therapy is begun. We describe a patient who was seen with hepatic disease and no neurological symptoms who became neurologically incapacitated soon after beginning penicillamine therapy. This case identifies an unexpected complication of penicillamine therapy that should be watched for in the presymptomatic patient who is beginning therapy.
患有威尔逊氏病神经症状和体征的患者在开始使用 D-青霉胺进行螯合治疗后，其病情常被发现会恶化。然而，症状前患者在开始适当治疗后预计不会出现神经表现。我们描述了一名患有肝病且无神经症状的患者，在开始青霉胺治疗后不久便出现神经功能丧失。该病例确定了青霉胺治疗一种意想不到的并发症，在开始治疗的症状前患者中应予以关注。
