TY  - JOUR
PY  - 2010//
TI  - Current state of Wilson disease patients in central Japan
JO  - Internal medicine
A1  - Tatsumi, Yasuaki
A1  - Hattori, Ai
A1  - Hayashi, Hisao
A1  - Ikoma, Jiro
A1  - Kaito, Masahiko
A1  - Imoto, Masami
A1  - Wakusawa, Shinya
A1  - Yano, Motoyoshi
A1  - Hayashi, Kazuhiko
A1  - Katano, Yoshiaki
A1  - Goto, Hidemi
A1  - Okada, Toshihide
A1  - Kaneko, Shuichi
SP  - 809
EP  - 815
VL  - 49
IS  - 9
N2  - OBJECTIVE: This study evaluated the current state of patients with Wilson disease in central Japan. PATIENTS AND METHODS: Between 1999 and 2007, 30 patients were diagnosed as having Wilson disease with an International Diagnostic Score of 4 or more. The phenotypes, genotypes and post-diagnostic courses of these patients were analyzed. RESULTS: Twenty-six patients had ATP7B mutations responsible for Wilson disease. Four patients had a single mutant chromosome. There were 2 major mutations of 2333 G>T and 2871 delC (40%), and 6 novel mutations (13%) in our patients. The first clinical manifestation was the hepatic form in 22, neurological form in 5, and hemolysis in 3 patients. The hepatic form was diagnosed around the age of 13 years, followed by neurological complication with a time lag of 9 years. Thus, some patients, especially patients with the neurological form, did not undergo early diagnostic tests including ATP7B analysis. During the post-diagnosis period, 3 patients were hospitalized for recurrent liver disease, and 2 patients committed suicide. One female patient died from acute hepatic failure associated with encephalopathy after fertilization therapy, while 2 male patients recovered from encephalopathy-free, prolonged hepatic failure after noncompliance with drug therapy. The King's Scores for liver transplantation were below the cut-off in both cases. CONCLUSION: To minimize delayed diagnosis, ceruloplasmin determination and ATP7B analysis may be recommended to patients showing hepatic damage of unknown etiology. At gene diagnosis, appropriate management of patients including compliance education and emotional care to prevent suicide might be important.<p />  <p>Language: en</p>
LA  - en
SN  - 0918-2918
UR  - http://dx.doi.org/
ID  - ref1
ER  -