Title: A Diagnostic Dilemma: Wilson’s Disease with Cutaneous Manifestations

Authors: Samar Pratim Nayak, Swati Dash, Bijayalaxmi Malick, Sunil Kumar Agarwala

 DOI: https://dx.doi.org/10.18535/jmscr/v11i6.15

Abstract

Wilson’s disease, an autosomal recessive disorder of copper metabolism, most commonly presents either with hepatic or neurological features. sometimes it may have certain atypical features like cutaneous and renal manifestations which may lead to diagnostic difficulties. we report here a case of Wilson disease who presented as Xerosis and generalised hyperpigmentation of body along with nephrotic range proteinuria. This case report is rare and highlights the fact that early recognition of skin lesions may play a role in diagnosis of Wilson’s disease and specific treatment can prevent further liver injury and neurological complications in most cases.

Keywords: xerosis, hyperpigmentation, Wilson’s disease, proteinuria.

References

  1. Merle U, Schaefer M, Ferenci P, Stremmel W. Clinical presentation, diagnosis and long-term outcome of Wilson’s disease: A cohort study. Gut 2007;56:115-20.
  2. Narayanan P, Chetan G, Mahadevan S. Wilson’s disease presenting as respiratory failure. Indian J Pediatr 2006;73:99-100.
  3. Eve A. Roberts1 and Michael L. Schilsky, Diagnosis and treatment of Wilson disease: An update. Hepatology. 2008;47(6): 2089-2111.
  4. SeyhanM ,Erdem T , Mukadder A. Selimo L and Ertekin V,Dermatological signs in Wilson’s disease. Pediatrics International. 2009; 51:395–398.
  5. Gurubacharya SM, Gurubacharya RL. Atypical presentation of Wilson's disease. J Nepal Paediatr Soc. 2008; 28:66–67.
  6. Steiner P, Frey P, Lupi GA, Kistler HJ. Familial Wilson's disease: Copper indued hemolysis, hypersplenism and hyperpigmentation as the main symptoms. Schweiz Med Wochenschr 1975; 105:872–879.
  7. Leu ML, Strickland GT, Wang CC, Chen TS. Skin pigmentation in Wilson's disease. JAMA. 1970;211:1542–1537.
  8. James WD, Berger TG ,Elston D.Errors in Metabolism. Andrews Diseases of the Skin. Clinical Dermatology, 10th edn . Saunders Elsevier, Canada. 2006
  9. Riyaz A. Wilson’s disease. In: Riyaz A, editor. Pediatric Gastroenterology and Hepatology. Hyderabad, New Delhi: Paras Medical Publisher; 2008. p. 551-68

Corresponding Author

Samar Pratim Nayak

Department of Pediatrics, SVPPGIP, SCB Medical College, Cuttack