Miranda M, Brinck P, Roessler J L, Troncoso Sch M, González M, Alarcón T, Villagra R
Servicio de Medicina, Hospital Félix Bulnes, Santiago de Chile.
Rev Med Chil. 1995 Sep;123(9):1098-107.
Wilson's Disease is an inherited disorder of copper metabolism. We report 16 patients (6 males) with the disease; 6 had hepatic involvement exclusively, 4 had neurological involvement, 3 had a neurological and hepatic involvement and 3 were asymptomatic. The age onset was 9 years for hepatic and 17 years for neurologic involvement. The mean delay in diagnosis was 14 months. Chronic hepatitis, cirrhosis and fulminant hepatic failure were the clinical forms of liver disease. Patients with neurologic disorders had behavioral disturbances and extrapyramidal manifestations such as dystonia and parkinsonism. Patients had a good response to penicillamine, except 3 that died of liver complications, in whom the treatment was delayed or discontinued. We conclude that this metabolic disease must be suspected in pubertal children and in adults of less than 30 years old with liver disease of unknown origin or behavioral alterations associated to an extrapyramidal syndrome.
威尔逊氏病是一种遗传性铜代谢紊乱疾病。我们报告了16例患有该疾病的患者(6名男性);其中6例仅累及肝脏,4例有神经系统受累,3例同时有神经和肝脏受累,3例无症状。肝脏受累的发病年龄为9岁,神经系统受累的发病年龄为17岁。诊断的平均延迟时间为14个月。慢性肝炎、肝硬化和暴发性肝衰竭是肝脏疾病的临床类型。患有神经系统疾病的患者有行为障碍和锥体外系表现,如肌张力障碍和帕金森综合征。除3例死于肝脏并发症(其治疗延迟或中断)外,患者对青霉胺治疗反应良好。我们得出结论,对于青春期儿童以及30岁以下患有不明原因肝病或与锥体外系综合征相关行为改变的成年人,必须怀疑患有这种代谢性疾病。