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Wilson's disease with superimposed autoimmune features: report of two cases and review.

Authors
  • Milkiewicz, P
  • Saksena, S
  • Hubscher, S G
  • Elias, E
Type
Published Article
Journal
Journal of gastroenterology and hepatology
Publication Date
May 01, 2000
Volume
15
Issue
5
Pages
570–574
Identifiers
PMID: 10847448
Source
Medline
License
Unknown

Abstract

We describe two females, 15 and 23 years old, respectively, who presented with classical features of Wilson's disease (WD) and several features of autoimmune hepatitis (AIH). The first patient was initially diagnosed as AIH and treated with prednisolone which caused clinical improvement, with an increase of serum albumin from 22 to 30 g/L, and a decrease of aspartate aminotransferase from 103 to 47 U/L. Subsequent diagnosis of WD and introduction of penicillamine gave excellent improvement and complete normalization of liver function tests. The second patient, at first also diagnosed as having AIH, was treated with steroids and azathioprine with initial improvement, but subsequent deterioration. The diagnosis of WD was made 2 years after initial diagnosis of AIH, as the patient reached end-stage liver disease and required a transplant. Therefore, d-penicillamine treatment was not attempted. We conclude that, in patients with AIH, a thorough screening for WD is necessary, particularly when the response to steroid therapy is poor. Conversely, in patients suffering from WD with superimposed features of AIH, a combination of steroids and penicillamine may be of benefit.

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