Panda with "Bright eyes" in Wilson′s disease

Abstract

We have highlighted herein an interesting, hitherto unusual, imaging feature in Wilson's disease, a rare but treatable autosomal recessive disorder of copper metabolism.A 16-year-old boy presented with progressive dysarthria, dysphagia, drooling, and declining scholastic performance of 1-year duration. Examination revealed bilateral dense Kayser-Fleischer rings, generalised rigidity, dystonia of the extremities, and short shuffling gait. Laboratory findings of reduced serum ceruloplasmin (3 mg/dl; N: 15-35), total copper (28 μg/dl; N: 75-160), and elevated 24-hour urinary copper (200 μg/24 hours; N: ≤70 mcg/24 hour) confirmed the diagnosis of Wilson's disease. He received de-coppering therapy with d-penicillamine and zinc sulphate as well as trihexyphenidyl and had symptomatic improvement.

Panda with “bright eyes”: a rare sign in Wilson disease

“…Brain MRI showed abnormal bilateral hyperintensities (Figure 1) and panda with "bright eyes" (Figure 2). Panda with "bright eyes" is a rare variant of the neuroimaging sign called "face of the giant panda", associated with Wilson disease 1,2 . It is probably related to paramagnetic effects of cooper and iron accumulation in the red nuclei.…”