September 1967

Wilson's Disease With Aseptic Meningitis and Penicillamine-Related Cheilosis

Arch Intern Med. 1967;120(3):374-376. doi:10.1001/archinte.1967.00300030116024

THIS report presents a case of Wilson's disease (hepatolenticular degeneration) with two unusual occurrences. The first was a syndrome of recurrent aseptic meningitis representing the initial evidence of a neurological disorder. The second was cheilosis and gingivostomatitis related to penicillamine therapy.

Report of a Case  A 19-year-old boy was admitted to Metropolitan Hospital in July 1965. In May of that year he had a sudden massive hematemesis. No demonstrable lesion was found on the barium meal roentgenogram, but a deficiency of clotting factors II, V, VII, IX, and X was noted in the blood. Medical history included glomerulonephritis and an anaphylactic penicillin reaction. There was no family history of liver or neurological disease and no previous history of jaundice, alcoholism, or ingestion of hepatotoxins.Physical findings were gynecomastia, splenomegaly, a small liver, and spider nevi. Significant laboratory results were as follows: serum protein, 7 gm/100 cc with 3.7 gm albumin

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