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威尔逊氏病:诊断检查与管理的最新进展

Wilson's Disease: An Update on the Diagnostic Workup and Management.

作者信息

Kasztelan-Szczerbinska Beata, Cichoz-Lach Halina

机构信息

Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, 8 Jaczewski Street, 20-954 Lublin, Poland.

出版信息

J Clin Med. 2021 Oct 30;10(21):5097. doi: 10.3390/jcm10215097.

Abstract

Wilson's disease (WD) is a rare autosomal recessive disorder of hepatocellular copper deposition. The diagnostic approach to patients with WD may be challenging and is based on a complex set of clinical findings that derive from patient history, physical examination, as well as laboratory and imaging testing. No single examination can unequivocally confirm or exclude the disease. Timely identification of signs and symptoms using novel biomarkers and modern diagnostic tools may help to reduce treatment delays and improve patient prognosis. The proper way of approaching WD management includes, firstly, early diagnosis and prompt treatment introduction; secondly, careful and lifelong monitoring of patient compliance and strict adherence to the treatment; and, last but not least, screening for adverse effects and evaluation of treatment efficacy. Liver transplantation is performed in about 5% of WD patients who present with acute liver failure at first disease presentation or with signs of decompensation in the course of liver cirrhosis. Increasing awareness of this rare inherited disease among health professionals, emphasizing their training to consider early signs and symptoms of the illness, and strict monitoring are vital strategies for the patient safety and efficacy of WD therapy.

摘要

威尔逊病(WD)是一种罕见的常染色体隐性肝细胞铜沉积疾病。对WD患者的诊断方法可能具有挑战性,它基于一系列复杂的临床发现,这些发现来自患者病史、体格检查以及实验室和影像学检查。没有单一的检查能够明确证实或排除该病。使用新型生物标志物和现代诊断工具及时识别体征和症状,可能有助于减少治疗延误并改善患者预后。WD管理的正确方法包括:首先,早期诊断并及时开始治疗;其次,仔细且终身监测患者的依从性以及严格坚持治疗;最后但同样重要的是,筛查不良反应并评估治疗效果。约5%的WD患者在首次发病时出现急性肝衰竭或在肝硬化过程中出现失代偿迹象时,会接受肝移植。提高卫生专业人员对这种罕见遗传病的认识,加强他们对疾病早期体征和症状的识别培训,以及严格监测,是确保WD治疗患者安全和疗效的关键策略。

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