Zinc monotherapy for young patients with oligosymptomatic Wilson disease: A single center, retrospective study - 11/11/21
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
| pages | 7 |
| Iconographies | 3 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | The current study aimed to evaluate the long-term efficacy of zinc monotherapy in oligosymptomatic patients and to analyze the possible factors that may influence the outcome of zinc monotherapy. |
• | We found that the baseline 24-h urine copper levels before treatment were significantly higher in patients with failure zinc monotherapy than that in those with successful zinc monotherapy. |
• | This study indicated that high initial 24 -h urinary copper levels may lead to treatment failure of zinc monotherapy in oligosymptomatic WD patients. |
Abstract |
Background and aims |
Few studies have focused on the treatment failure of zinc monotherapy for oligosymptomatic Wilson disease (WD) patients. Therefore, we aimed to evaluate the long-term efficacy of zinc monotherapy in oligosymptomatic patients and to analyze the possible factors that may influence the outcome of this treatment.
Methods |
We retrospectively reviewed the medical records of oligosymptomatic WD patients who received zinc monotherapy from the time of diagnosis. Then, the characteristics of patients who were treated with zinc monotherapy successfully and those who experienced treatment failure were investigated.
Results |
Forty oligosymptomatic WD patients were identified that have received zinc monotherapy as initial treatment, with a median age of 3.83 years at the time of diagnosis. 36 (90%) patients had abnormal alanine transaminase/aspartate transaminase levels at baseline. None of the patients became symptomatic during zinc monotherapy. 28 (70%, Group 1) patients were treated with zinc monotherapy successfully for a median period of 2.4 years. In Group 1, serum aminotransferase levels significantly decreased 6 and 12 months after zinc therapy compared to the baseline levels (P < 0.05). 12 (30%, Group 2) patients experienced treatment failure with zinc monotherapy due to uncontrolled serum liver enzyme levels, and d-penicillamine was combined. The baseline 24-hour urine copper levels before treatment were significantly higher in Group 2 compared to that in Group 1 (182.5 vs 90.92 μg /day, P = 0.018). Comparing the age at onset; ceruloplasmin, serum copper, ALT, and AST levels; and proportions of abdominal ultrasonography abnormality at baseline between Group 1 and 2 revealed no statistically significant differences.
Conclusions |
We found that high initial 24 -h urinary copper levels may lead to treatment failure of zinc monotherapy in oligosymptomatic WD patients. It might be reasonable to follow up liver function tests more closely during zinc monotherapy and to begin combination treatment with chelators early in patients with high level of 24 -h urinary copper.
Le texte complet de cet article est disponible en PDF.Abbreviations : WD, DPA, ALT, AST, SD
Keywords : Wilson disease, Oligosymptomatic, Zinc monotherapy, Treatment failure, Urine copper, D-penicillamine
Plan
Vol 45 - N° 6
Article 101623- novembre 2021 Retour au numéro
Article précédent
- Novel albumin, bilirubin and platelet criteria for the exclusion of high-risk varices in compensated advanced chronic liver disease: A validation study
- Yu Jun Wong, Guan Sen Kew, Poh Seng Tan, Zhaojin Chen, Martin Putera, Wenjun Alexander Yip, Tiing Leong Ang, Kwong Ming Fock, Guan Huei Lee, John Hsiang, Daniel Q. Huang, Andrew Kwek, Mark D. Muthiah, Rahul Kumar, Malcolm Tan, Jessica Tan, Prem Harichander Thurairajah, Eng Kiong Teo, Bee Choo Tai, Seng Gee Lim
- Hepatotoxicity of iodine-131 ablation for post-surgical differentiated thyroid cancer patients with hepatitis B virus infection
- Zhishuo Mo, Ziying Lei, Peipei Wang, Zhebin Wu, Haijuan Yuan, Dongying Xie, Zeqian Wu, Zenan Huang
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?