A patient with cryptogenic cirrhosis was found to have corneal pigmentation rings indistinguishable from Kayser-Fleischer rings on slit-lamp examination. Although she had hepatic encephalopathy that included confusion, tremor, and slurred speech, diagnosis of Wilson's disease was ruled out because urinary cooper excretion and hepatic copper concentrations were below the range found in symptomatic Wilson's disease. The exact nature of these rings could not be determined, and they were considered as Kayser-Fleischer-like rings.
(Arch Intern Med 138:1857-1858, 1978)
Rimola A, Bruguera M, Rodés J. Kayser-Fleischer-like Ring in a Cryptogenic Cirrhosis. Arch Intern Med. 1978;138(12):1857-1858. doi:10.1001/archinte.1978.03630370065028