[PDF] Wilson's disease in children : a position paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition

Source:
European Society for Paediatric Gastroenterology Hepatology and Nutrition
Publisher:
European Society for Paediatric Gastroenterology Hepatology and Nutrition
Publication date:
01 February 2018

Abstract

Clinical presentations of Wilson's disease (WD) in childhood ranges from asymptomatic liver disease to cirrhosis or acute liver failure, whereas neurological and psychiatric symptoms are rare. The basic diagnostic approach includes serum ceruloplasmin and 24-hour urinary copper excretion. Final diagnosis of WD can be established using a diagnostic scoring system based on symptoms, biochemical tests assessing copper metabolism, and molecular analysis of mutations in the ATP7B gene. Pharmacological treatment is life-long and aims at removal of copper excess by chelating agents as D-penicillamine, trientine, or inhibition of intestinal copper absorption with zinc salts. Acute liver failure often requires liver transplantation. This publication aims to provide recommendations for diagnosis, treatment, and follow-up of WD in children.