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April 1989

Deterioration of Wilson's Disease Following the Start of Penicillamine Therapy-Reply

Author Affiliations

Departments of Human Genetics and Internal Medicine University of Michigan Medical School Ann Arbor, MI 48109
Department of Human Genetics University of Michigan Medical School

Arch Neurol. 1989;46(4):360-361. doi:10.1001/archneur.1989.00520400014008

In Reply.  —We wish to respond to certain elements in the accompanying LETTERS TO THE EDITOR by Hoogenraad and Van Hattum and by Pall and coworkers concerning our recent article in the Archives.1Hoogenraad and Van Hattum say "it would have been better to start treatment with zinc" in the patient in the case report, and "it is difficult to understand why Brewer and coworkers waited so long to switch over to zinc therapy." We made it clear in the article that the patient had been started on penicillamine by other physicians and the patient was not referred to us until six weeks after therapy had been initiated. As we said in the article, we did not switch the patient over to zinc therapy at that point, because we believed that the patient had already been through the syndrome of neurologic worsening from penicillamine. As our data show in the Archives

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