РЕЗУЛЬТАТЫ ПЕРВИЧНОГО ОБСЛЕДОВАНИЯ ПАЦИЕНТОВ С УСТАНОВЛЕННОЙ БОЛЕЗНЬЮ ВИЛЬСОНА-КОНОВАЛОВА

O. A. Zhigaltsova-Kuchinskaya; N. N.  Silivontchik; S. A. Likhachev; I. V. Pleshko; A. A. Klyuchareva; G. D. Sitnik

doi:10.25298/2616-5546-2021-5-2-161-167

O. A. Zhigaltsova-Kuchinskaya Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus https://orcid.org/0000-0001-6887-4917
N. N. Silivontchik Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus https://orcid.org/0000-0002-8070-7385
S. A. Likhachev National Scientific and Practical Center of Neurology and Neurosurgery, Minsk, Belarus https://orcid.org/0000-0002-6019-042X
I. V. Pleshko National Scientific and Practical Center of Neurology and Neurosurgery, Minsk, Belarus https://orcid.org/0000-0002-6473-050X
A. A. Klyuchareva Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus https://orcid.org/0000-0001-6420-289X
G. D. Sitnik Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus https://orcid.org/0000-0002-9366-6789

DOI: https://doi.org/10.25298/2616-5546-2021-5-2-161-167

Keywords: Wilson disease, diagnosis, copper, ATP7B

Abstract

Bacground. The optimization of Wilson’s disease (WD) diagnosis is one of the most disputable problem. Objective. The retrospective study of initial assessment findings under clinical suspicion for WD in 102 patients with the confirmed diagnosis. Material and methods. The results of laboratory tests and Kaiser-Fleischer rings (KF rings) identification under clinical suspicion for WD in 102 patients with the confirmed diagnosis. Results. At stage I, 17 patients (16.7%; 95% CI 10.7–25.1) were defined as having clinically definitive WD based on the combination of low serum ceruloplasmin and KF rings, 4 patients (3.9%; 95% CI 1.5–9.7) – based on the drop of ceruloplasmin level. After stage II, involving 24-hour urinary copper excretion evaluation, the rate of definitive diagnosis of WD reached 24,5% (95% CI 17.2 33.7). After stage III (genotyping for carriage of ATP7B gene mutations) – 56.9% (95% CI 47.2–66.0). Serum free copper increase was found in 54.9% (95% CI 41.4 67.7) of cases. Conclusions. Under clinical suspicion for WD, initial structured ophthalmological, laboratory and molecular-genetic assessment ensured the diagnosis of WD only in 56.9% (95% CI 56.9; 47.2–66.1). Frequent detection of serum free copper increase (54.9%, 95% CI 41.4 67.7) allows to use this test due to its greater availability as compared with 24-hour urinary copper excretion evaluation in WD diagnostics.

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INITIAL ASSESSMENT FINDINGS IN PATIENTS WITH CONFIRMED WILSON’S DISEASE

Abstract

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