Begum Fahmida, Datta Amit Kumar, Nahid Khan Lamia, Jesmin Tahmina, Musabbir Nadira, Mazumder Md Wahiduzzaman, Fatema Kanij, Rukunuzzaman Md, Karim Abu Sayd Mohammad Bazlul, Chowdhury Faisal, Iktidar Mohammad Azmain
Department of Paediatric Gastroenterology and Nutrition, Bangladesh Medical University, Dhaka, Bangladesh.
Department of Paediatric Nephrology, Bangladesh Medical University, Dhaka, Bangladesh.
BMJ Paediatr Open. 2025 Sep 4;9(1):e003718. doi: 10.1136/bmjpo-2025-003718.
Diagnosing Wilson's disease (WD) in children remains a significant challenge. This study evaluated spot urinary copper/creatinine (Cu/Cr) ratio for paediatric WD diagnosis in Bangladesh. 60 children (30 WD, 30 non-WD by Leipzig criteria) were enrolled, and the spot morning urinary Cu/Cr and 24-hour urinary copper were measured. The spot Cu/Cr ratio was significantly higher in patients with WD (median 0.2597 vs 0.0101, p<0.001) and correlated strongly with 24-hour urinary copper (r=0.697). A cut-off of 0.01604 yielded 90% sensitivity and specificity (AUC 0.920). Spot urinary Cu/Cr ratio is an accurate, non-invasive tool for paediatric WD diagnosis, particularly in resource-limited settings. These promising initial findings highlight its potential, though further comprehensive validation in larger and diverse populations is essential to confirm its reliability and generalisability.
诊断儿童威尔逊病（WD）仍然是一项重大挑战。本研究评估了孟加拉国儿童WD诊断中晨尿铜/肌酐（Cu/Cr）比值。招募了60名儿童（30名WD患者，30名根据莱比锡标准诊断为非WD患者），并测量了晨尿Cu/Cr比值和24小时尿铜含量。WD患者的晨尿Cu/Cr比值显著更高（中位数0.2597对0.0101，p<0.001），且与24小时尿铜含量密切相关（r=0.697）。截断值为0.01604时，敏感性和特异性均为90%（曲线下面积0.920）。晨尿Cu/Cr比值是诊断儿童WD的一种准确、非侵入性工具，尤其适用于资源有限的环境。这些初步的有前景的发现凸显了其潜力，不过在更大且多样化的人群中进行进一步全面验证对于确认其可靠性和普遍性至关重要。
