Wilson's disease

Abstract

In their Seminar on Wilson's disease,1Ala A Walker AP Ashkan K Dooley JS Schilsky ML Wilson's disease.Lancet. 2007; 369: 397-408Summary Full Text Full Text PDF PubMed Scopus (831) Google Scholar Aftab Ala and colleagues omitted a few clinical observations.We have found that Kayser-Fleischer rings are more common in patients who present with neurological symptoms as the initial manifestation of Wilson's disease (23 of 24) than in those with hepatic symptoms at presentation (30 of 36).2Raiamani K Sharma RN John G Raju JM Ganesh A John L Wilson's disease in India: clinical and laboratory manifestations in thirty patients.J Assoc Physicians India. 1987; 35: 438-441PubMed Google Scholar, 3Richard VS Harris VK Shankar V Loganathan G Chandy GM Clinical manifestations and survival pattern of Wilson's disease.Natl Med J India. 2000; 13: 301-303PubMed Google Scholar It is therefore essential that a thorough examination of the eye is done in any patient who presents with neurological and neuropsychiatric symptoms.We have also shown that those presenting with liver symptoms had a fivefold increase in mortality compared with those who had neurological symptoms at presentation.2Raiamani K Sharma RN John G Raju JM Ganesh A John L Wilson's disease in India: clinical and laboratory manifestations in thirty patients.J Assoc Physicians India. 1987; 35: 438-441PubMed Google Scholar Liver transplantation would therefore be more appropriate in this group.We declare that we have no conflict of interest. In their Seminar on Wilson's disease,1Ala A Walker AP Ashkan K Dooley JS Schilsky ML Wilson's disease.Lancet. 2007; 369: 397-408Summary Full Text Full Text PDF PubMed Scopus (831) Google Scholar Aftab Ala and colleagues omitted a few clinical observations. We have found that Kayser-Fleischer rings are more common in patients who present with neurological symptoms as the initial manifestation of Wilson's disease (23 of 24) than in those with hepatic symptoms at presentation (30 of 36).2Raiamani K Sharma RN John G Raju JM Ganesh A John L Wilson's disease in India: clinical and laboratory manifestations in thirty patients.J Assoc Physicians India. 1987; 35: 438-441PubMed Google Scholar, 3Richard VS Harris VK Shankar V Loganathan G Chandy GM Clinical manifestations and survival pattern of Wilson's disease.Natl Med J India. 2000; 13: 301-303PubMed Google Scholar It is therefore essential that a thorough examination of the eye is done in any patient who presents with neurological and neuropsychiatric symptoms. We have also shown that those presenting with liver symptoms had a fivefold increase in mortality compared with those who had neurological symptoms at presentation.2Raiamani K Sharma RN John G Raju JM Ganesh A John L Wilson's disease in India: clinical and laboratory manifestations in thirty patients.J Assoc Physicians India. 1987; 35: 438-441PubMed Google Scholar Liver transplantation would therefore be more appropriate in this group. We declare that we have no conflict of interest.