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Zinc therapy of Wilson's disease: Two views
Author(s) -
Brewer George J.,
Scheinberg I. Herbert
Publication year - 1986
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840060540
Subject(s) - penicillamine , excretion , copper , zinc , wilson's disease , urinary system , medicine , liver biopsy , chemistry , endocrinology , zoology , gastroenterology , physiology , biopsy , disease , biology , organic chemistry
After initial promotion of copper excretion with D‐penicillamine, the effect of oral zinc sulphate (3×150 mg/day, loading dose; 3×100 mg/day, maintenance dose) in two children with clinically stable Wilson's disease was evaluated after completion of three years' treatment. The course, judged by clinical, biochemical, and histological parameters was satisfactory in both. The urinary copper concentration reverted to less than 1.26 μmol/24 hours; and the serum copper concentration decreased further during zinc sulphate treatment. In one child the rise in 24 hour urinary copper excretion observed after a challenge dose of D‐penicillamine (±20 mg/kg) remained constant throughout the period of observation while the liver copper content fell from 1460 μg/g dry weight to 890 μg/g dry weight. In the other patient, however, the liver copper content as well as the 24 hour urinary copper excretion increased after D‐penicillamine challenge during the third year of treatment. We conclude that zinc sulphate is a low toxic and well tolerated alternative for D‐penicillamine. The dosage depends, however, on individual factors not yet well understood, and we recommend restriction of its use to patients who do not tolerate D‐penicillamine well. We suggest monitoring of treatment with yearly D‐penicillamine challenge and a liver biopsy if liver function deteriorates.