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神经型威尔逊病:流行病学、临床表现、诊断与治疗

Neurological-Type Wilson Disease: Epidemiology, Clinical Manifestations, Diagnosis, and Management.

作者信息

Kipker Nathaniel, Alessi Kaitlyn, Bojkovic Marko, Padda Inderbir, Parmar Mayur S

机构信息

Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.

Foundational Sciences, Barry University, Miami, USA.

出版信息

Cureus. 2023 Apr 26;15(4):e38170. doi: 10.7759/cureus.38170. eCollection 2023 Apr.

Abstract

Wilson disease (WD) is a complex metabolic disorder caused by disruptions to copper regulation within the body, leading to an unregulated accumulation of copper within various tissues. A less understood organ affected by the collection of copper is the brain, which further leads to the generation of oxygen-free radicals and resultant demyelination. Healthcare providers must keep the neurological form of WD in their list of differentials when patients present with diverse neurological manifestations. The initial step to diagnosis will be to distinguish the characteristic disease presentation with a thorough history and physical and neurological examination. A high clinical disease suspicion of WD should warrant further investigation by laboratory workup and imaging modalities to support the clinical findings and confirm the diagnosis of WD. Once a WD diagnosis is established, the healthcare provider should treat the underlying biological process of WD symptomatically. This review article discusses the epidemiology and pathogenesis of the neurological form of WD, its clinical and behavioral implications, diagnostic features, and treatment modalities (current and emerging therapies), further aiding healthcare professionals in early diagnosis and management strategies.

摘要

威尔逊病(WD)是一种复杂的代谢紊乱疾病,由体内铜调节紊乱引起,导致铜在各种组织中不受控制地积累。受铜聚集影响的一个了解较少的器官是大脑,这进一步导致氧自由基的产生和由此产生的脱髓鞘。当患者出现各种神经症状时,医疗服务提供者必须将WD的神经形式列入鉴别诊断清单。诊断的第一步将是通过全面的病史、体格和神经检查来区分特征性疾病表现。对WD的高度临床怀疑应通过实验室检查和影像学检查进行进一步调查,以支持临床发现并确诊WD。一旦确诊WD,医疗服务提供者应针对WD的潜在生物学过程进行对症治疗。这篇综述文章讨论了WD神经形式的流行病学和发病机制、其临床和行为影响、诊断特征以及治疗方式(当前和新兴疗法),进一步帮助医疗专业人员进行早期诊断和管理策略。

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