Case report of anorexia nervosa associated with Wilson's disease

Abstract

Wilson's disease is a recessively inherited disorder of copper metabolism with prominent hepatic, hematopoetic, central nervous system (CNS), and ocular involvement. Psychiatric manifestations are notoriously variable. The following case history of a patient with both anorexia nervosa and Wilson's disease is presented and discussed in the context of organic CNS lesions associated with anorexia nervosa‐like syndromes. © 1993 by John Wiley & Sons, Inc.

Value of liver biopsy in anorexia nervosa‐related transaminitis: A case study and literature review

“…An additional article was identified through reference review. Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug‐induced liver inury, and heterozygous hemochromatosis 15–18 . In total, 31 cases were identified from selected publications.…”

“…However, in the case by Ohno et al (2014), the finding of NASH on biopsy prompted the clinician to start prednisolone and pioglitazone, despite potential side effects of the latter 30 . Similarly, in two of the excluded cases, the biopsy was critical in diagnosing Wilson disease and olanzapine‐induced liver injury, which were treated with D‐penicillamine and drug‐cessation, respectively 17,18 …”

“…Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug-induced liver inury, and heterozygous hemochromatosis. [15][16][17][18] In total, 31 cases were identified from selected publications. Among the 32 cases (including our case), 29 (88%) were female.…”

Value of liver biopsy in anorexia nervosa‐related transaminitis: A case study and literature review

“…An additional article was identified through reference review. Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug‐induced liver inury, and heterozygous hemochromatosis 15–18 . In total, 31 cases were identified from selected publications.…”

“…However, in the case by Ohno et al (2014), the finding of NASH on biopsy prompted the clinician to start prednisolone and pioglitazone, despite potential side effects of the latter 30 . Similarly, in two of the excluded cases, the biopsy was critical in diagnosing Wilson disease and olanzapine‐induced liver injury, which were treated with D‐penicillamine and drug‐cessation, respectively 17,18 …”

“…Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug-induced liver inury, and heterozygous hemochromatosis. [15][16][17][18] In total, 31 cases were identified from selected publications. Among the 32 cases (including our case), 29 (88%) were female.…”

Resolved Psychosis after Liver Transplantation in a Patient with Wilson’s Disease

“…Emotional lability, lack of appropriate emotions, personality changes, increased or reduced sexual interest, cognitive impairment, schizofrenia, nervous anorexia [18] and catatonia [19] have also been described [4]. …”

Clinical Picture of a Patient With a Novel PSEN1 Mutation (L424V)

“…In fact the first behavioral and cognitive symptoms, as well as the mild cerebral atrophy seen on the first neuroimages, could be attributable to the prolonged anorexia, and we might expect them to be reversible if anorexia were successfully resolved and normal weight recovered. [1][2][3][4][5][6] Laboratory workup ruled out other causes sometimes associated with anorexia nervosa, such as Lyme disease, 7,8 HIV infection, 9,10 Wilson's disease, 11 or tumors in the hypothalamic-hypophyseal region. 12 The progressive clinical picture developed after the age of 30 comprises outstanding early behavioral symptoms as well as attention, memory, lenguage, praxis, executive, and movement disorder.…”

Value of liver biopsy in anorexia nervosa‐related transaminitis: A case study and literature review

“…An additional article was identified through reference review. Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug‐induced liver inury, and heterozygous hemochromatosis 15–18 . In total, 31 cases were identified from selected publications.…”

“…However, in the case by Ohno et al (2014), the finding of NASH on biopsy prompted the clinician to start prednisolone and pioglitazone, despite potential side effects of the latter 30 . Similarly, in two of the excluded cases, the biopsy was critical in diagnosing Wilson disease and olanzapine‐induced liver injury, which were treated with D‐penicillamine and drug‐cessation, respectively 17,18 …”

“…Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug-induced liver inury, and heterozygous hemochromatosis. [15][16][17][18] In total, 31 cases were identified from selected publications. Among the 32 cases (including our case), 29 (88%) were female.…”

Resolved Psychosis after Liver Transplantation in a Patient with Wilson’s Disease

“…Emotional lability, lack of appropriate emotions, personality changes, increased or reduced sexual interest, cognitive impairment, schizofrenia, nervous anorexia [18] and catatonia [19] have also been described [4]. …”

Clinical Picture of a Patient With a Novel PSEN1 Mutation (L424V)

“…In fact the first behavioral and cognitive symptoms, as well as the mild cerebral atrophy seen on the first neuroimages, could be attributable to the prolonged anorexia, and we might expect them to be reversible if anorexia were successfully resolved and normal weight recovered. [1][2][3][4][5][6] Laboratory workup ruled out other causes sometimes associated with anorexia nervosa, such as Lyme disease, 7,8 HIV infection, 9,10 Wilson's disease, 11 or tumors in the hypothalamic-hypophyseal region. 12 The progressive clinical picture developed after the age of 30 comprises outstanding early behavioral symptoms as well as attention, memory, lenguage, praxis, executive, and movement disorder.…”

Value of liver biopsy in anorexia nervosa‐related transaminitis: A case study and literature review

“…An additional article was identified through reference review. Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug‐induced liver inury, and heterozygous hemochromatosis 15–18 . In total, 31 cases were identified from selected publications.…”

“…However, in the case by Ohno et al (2014), the finding of NASH on biopsy prompted the clinician to start prednisolone and pioglitazone, despite potential side effects of the latter 30 . Similarly, in two of the excluded cases, the biopsy was critical in diagnosing Wilson disease and olanzapine‐induced liver injury, which were treated with D‐penicillamine and drug‐cessation, respectively 17,18 …”

“…Four articles were excluded due to concomitant diagnosis of Wilson disease, celiac disease, drug-induced liver inury, and heterozygous hemochromatosis. [15][16][17][18] In total, 31 cases were identified from selected publications. Among the 32 cases (including our case), 29 (88%) were female.…”

Resolved Psychosis after Liver Transplantation in a Patient with Wilson’s Disease

“…Emotional lability, lack of appropriate emotions, personality changes, increased or reduced sexual interest, cognitive impairment, schizofrenia, nervous anorexia [18] and catatonia [19] have also been described [4]. …”

Clinical Picture of a Patient With a Novel PSEN1 Mutation (L424V)

“…In fact the first behavioral and cognitive symptoms, as well as the mild cerebral atrophy seen on the first neuroimages, could be attributable to the prolonged anorexia, and we might expect them to be reversible if anorexia were successfully resolved and normal weight recovered. [1][2][3][4][5][6] Laboratory workup ruled out other causes sometimes associated with anorexia nervosa, such as Lyme disease, 7,8 HIV infection, 9,10 Wilson's disease, 11 or tumors in the hypothalamic-hypophyseal region. 12 The progressive clinical picture developed after the age of 30 comprises outstanding early behavioral symptoms as well as attention, memory, lenguage, praxis, executive, and movement disorder.…”