Development of Neurologic Symptoms in a Patient With Asymptomatic Wilson's Disease Treated With Penicillamine

Early neurological deterioration in Wilson’s disease: a systematic literature review and meta-analysis

“…We documented that early neurological deterioration in WD occurred in about 14% of all WD patients and 21.8% of patients with neurological symptom. These data show that this phenomenon may currently occur less frequently than reported previously, particularly in some older review studies, which cited frequency up to 50% [ 15 – 18 , 24 ]. A potential reason for this difference is that DPA was the first drug introduced as a WD treatment and initial reports of early neurological deterioration were mostly describing DPA-treated patients.…”

Early neurological deterioration in Wilson’s disease: a systematic literature review and meta-analysis

“…We documented that early neurological deterioration in WD occurred in about 14% of all WD patients and 21.8% of patients with neurological symptom. These data show that this phenomenon may currently occur less frequently than reported previously, particularly in some older review studies, which cited frequency up to 50% [ 15 – 18 , 24 ]. A potential reason for this difference is that DPA was the first drug introduced as a WD treatment and initial reports of early neurological deterioration were mostly describing DPA-treated patients.…”

Systematic review: clinical efficacy of chelator agents and zinc in the initial treatment of Wilson disease

“…Initial neurological worsening is thought to reflect the mobilization of hepatic copper by d ‐penicillamine into the circulation and its redistribution in the brain 70 . d ‐Penicillamine has also been reported in two case reports to cause the onset of neurological disease when used as initial therapy in presymptomatic patients 69–72 …”

Wilson's Disease Suspected to Involve a Novel Genetic Mutation of ATP7B Gene, Requiring a Differential Diagnosis with Non-alcoholic Steatohepatitis

“…The first-line treatment for WD is generally a copper-chelating agent, such as D-penicillamine ( 1 - 3 ), but the high frequency of side effects (20-25%) and reported cases of neurological deterioration warrant caution ( 19 , 20 ). Monotherapy with zinc acetate is recommended ( 21 , 22 ).…”

Early neurological deterioration in Wilson’s disease: a systematic literature review and meta-analysis

“…We documented that early neurological deterioration in WD occurred in about 14% of all WD patients and 21.8% of patients with neurological symptom. These data show that this phenomenon may currently occur less frequently than reported previously, particularly in some older review studies, which cited frequency up to 50% [ 15 – 18 , 24 ]. A potential reason for this difference is that DPA was the first drug introduced as a WD treatment and initial reports of early neurological deterioration were mostly describing DPA-treated patients.…”

Systematic review: clinical efficacy of chelator agents and zinc in the initial treatment of Wilson disease

“…Initial neurological worsening is thought to reflect the mobilization of hepatic copper by d ‐penicillamine into the circulation and its redistribution in the brain 70 . d ‐Penicillamine has also been reported in two case reports to cause the onset of neurological disease when used as initial therapy in presymptomatic patients 69–72 …”

Wilson's Disease Suspected to Involve a Novel Genetic Mutation of ATP7B Gene, Requiring a Differential Diagnosis with Non-alcoholic Steatohepatitis

“…The first-line treatment for WD is generally a copper-chelating agent, such as D-penicillamine ( 1 - 3 ), but the high frequency of side effects (20-25%) and reported cases of neurological deterioration warrant caution ( 19 , 20 ). Monotherapy with zinc acetate is recommended ( 21 , 22 ).…”

Early neurological deterioration in Wilson’s disease: a systematic literature review and meta-analysis

“…We documented that early neurological deterioration in WD occurred in about 14% of all WD patients and 21.8% of patients with neurological symptom. These data show that this phenomenon may currently occur less frequently than reported previously, particularly in some older review studies, which cited frequency up to 50% [ 15 – 18 , 24 ]. A potential reason for this difference is that DPA was the first drug introduced as a WD treatment and initial reports of early neurological deterioration were mostly describing DPA-treated patients.…”

Systematic review: clinical efficacy of chelator agents and zinc in the initial treatment of Wilson disease

“…Initial neurological worsening is thought to reflect the mobilization of hepatic copper by d ‐penicillamine into the circulation and its redistribution in the brain 70 . d ‐Penicillamine has also been reported in two case reports to cause the onset of neurological disease when used as initial therapy in presymptomatic patients 69–72 …”

Wilson's Disease Suspected to Involve a Novel Genetic Mutation of ATP7B Gene, Requiring a Differential Diagnosis with Non-alcoholic Steatohepatitis

“…The first-line treatment for WD is generally a copper-chelating agent, such as D-penicillamine ( 1 - 3 ), but the high frequency of side effects (20-25%) and reported cases of neurological deterioration warrant caution ( 19 , 20 ). Monotherapy with zinc acetate is recommended ( 21 , 22 ).…”