神经精神状态正常的迟发性威尔逊病：一例报告
Late onset Wilson Disease with normal neuro-psychiatric status: A case report.
作者信息
Dhakal Bishal, Prabhat K C, Karki Abinash, Bhattarai Ayush Mohan, Sapkota Sachin, Subedi Binaya, Dahal Abhinav
机构信息
Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
Maulakalika Hospital Pvt. Ltd., Bharatpur, 10-Chitwan, Nepal.
出版信息
Ann Med Surg (Lond). 2022 May 6;77:103678. doi: 10.1016/j.amsu.2022.103678. eCollection 2022 May.
INTRODUCTION
Late onset Wilson disease (WD) is a rare form of WD. WD has variability of clinical presentations from acute liver failure to chronic liver disease (CLD). The hepatic and neurological variants of WD have wider variations.
CASE PRESENTATION
A 55-year-old female, known case of CLD, presenting with generalized body swelling and abdominal pain, was diagnosed with late onset WD with normal neuro-psychiatric status. She was treated with zinc and considered for liver transplantation.
CLINICAL DISCUSSION
Late onset WD is itself a rare form of WD. Within it, neurological manifestations are common in late onset WD, which was quite opposite as compared to our case. Similarly, diagnostic delay has been a concern in late onset WD with CLD as with our case.
CONCLUSIONS
In spite of being uncommon in later age, WD and its different variations like with normal neuro-psychiatric status should be considered as an etiology in cases of unexplained liver diseases.
引言
迟发性威尔逊病（WD）是WD的一种罕见形式。WD的临床表现具有多样性，从急性肝衰竭到慢性肝病（CLD）不等。WD的肝脏和神经学变体有更广泛的变化。
病例介绍
一名55岁女性，已知患有CLD，出现全身肿胀和腹痛，被诊断为迟发性WD，神经精神状态正常。她接受了锌治疗并被考虑进行肝移植。
临床讨论
迟发性WD本身就是WD的一种罕见形式。在其中，神经学表现在迟发性WD中很常见，这与我们的病例情况相反。同样，与我们的病例一样，诊断延迟一直是迟发性WD合并CLD的一个问题。
结论
尽管WD在老年时并不常见，但在不明原因肝病的病例中，应将WD及其不同变体（如神经精神状态正常的情况）视为病因。
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