0
Article |

Dangers of Interrupting Decoppering Treatment in Wilson's Disease

Tjaard U. Hoogenraad, MD
Arch Neurol. 1994;51(10):972-973. doi:10.1001/archneur.1994.00540220018005
Text Size: A A A
Published online

In their letter to the editor, Lang et al1 reported on the fatal outcome of a 30-year-old male patient with Wilson's disease. He was known to have had the disease since the age of 13 years and had been administered penicillamine therapy. However, he had discontinued the treatment, because he had felt perfectly sound. After about 3 years without medication, he started treatment with oral zinc sulfate at a dose of 200 mg thrice daily. During the first 4 weeks, he continued to feel quite well, but thereafter he began to develop symptoms indicative of progressive hepatic failure, while he also developed neurologic symptoms. After treatment with penicillamine was resumed, his hepatic and neurologic conditions deteriorated. While the patient was receiving a highdose penicillamine, the neurologic deterioration became severe and he died after esophageal hemorrhaging and failure of central cerebral regulation.

The authors made reference to the letter to

REFERENCES

Lang CJG, Rabas-Kolominsky P, Engelhardt A, Kobras G, Konig HJ.  Fatal deterioration of Wilson's disease after institution of oral zinc therapy . Arch Neurol . 1993;;50:1007-1008.
Hoogenraad TU, Van Hattum J.  Zinc therapy as the initial treatment for Wilson's disease . Arch Neurol . 1988;;45:373-374.
Scheinberg IH, Sternlieb I.  Wilson's disease . In: Major Problems in Internal Medicine . Philadelphia, Pa: WB Saunders Co; 1984;;23.
Hoogenraad TU, Van den Hamer CJ, Koevoet R, De-Ruyter-Korver EG.  Oral zinc in Wilson's disease . Lancet . 1978;;2:1262-1263.
Hoogenraad TU, Van den Hamer CJA, Van Hattum J.  Effective treatment of Wilson's disease with oral zinc sulphate: two case reports . BMJ . 1984;;289: 273-276.
Scheinberg IH, Jaffe ME, Sternlieb I.  The use of trientine in preventing the effects of interrupting penicillamine therapy in Wilson's disease . N Engl J Med . 1987;;317:209-213.
Danks DM.  Copper and liver disease . Eur J Pediatr . 1993;;150:142-148.
Walshe J, Dixon AK.  Dangers of non-compliance in Wilson's disease . Lancet . 1986;;1:845-846.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Lang CJG, Rabas-Kolominsky P, Engelhardt A, Kobras G, Konig HJ.  Fatal deterioration of Wilson's disease after institution of oral zinc therapy . Arch Neurol . 1993;;50:1007-1008.
Hoogenraad TU, Van Hattum J.  Zinc therapy as the initial treatment for Wilson's disease . Arch Neurol . 1988;;45:373-374.
Scheinberg IH, Sternlieb I.  Wilson's disease . In: Major Problems in Internal Medicine . Philadelphia, Pa: WB Saunders Co; 1984;;23.
Hoogenraad TU, Van den Hamer CJ, Koevoet R, De-Ruyter-Korver EG.  Oral zinc in Wilson's disease . Lancet . 1978;;2:1262-1263.
Hoogenraad TU, Van den Hamer CJA, Van Hattum J.  Effective treatment of Wilson's disease with oral zinc sulphate: two case reports . BMJ . 1984;;289: 273-276.
Scheinberg IH, Jaffe ME, Sternlieb I.  The use of trientine in preventing the effects of interrupting penicillamine therapy in Wilson's disease . N Engl J Med . 1987;;317:209-213.
Danks DM.  Copper and liver disease . Eur J Pediatr . 1993;;150:142-148.
Walshe J, Dixon AK.  Dangers of non-compliance in Wilson's disease . Lancet . 1986;;1:845-846.

Correspondence

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.