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October 1993

Fatal Deterioration of Wilson's Disease After Institution of Oral Zinc Therapy

Author Affiliations

Department of Neurology University of Erlangen-Nuremberg Schwabachanlage 6 D-8520 Erlangen (W) Germany
Department of Pathology
Department of Internal Medicine I University of Erlangen-Nuremberg Krankenhausstrasse 12 D-8520 Erlangen (W) Germany

Arch Neurol. 1993;50(10):1007-1008. doi:10.1001/archneur.1993.00540100008005

To the Editor.  —In their letter to the editor, Hoogenraad and van Hattum claimed that "worsening of neurologic signs after the start of zinc therapy has never been described."1 Herein, we report such a case.

Report of a Case.  —A 30-year-old right-handed male student was known to have suffered from Wilson's disease since the age of 13 years. He had Kayser-Fleischer corneal rings, low serum copper level, abnormally high urine copper excretion, very low serum ceruloplasmin level, and high hepatic copper content. Roentgenographic computed tomography and magnetic resonance imaging during the last year of his life showed the characteristic bilateral basal ganglia lesions. His sister had the same disease, while his brother was not affected.d-Penicillamine (300 mg orally) and potassium sulfide (20 mg orally) were given thrice daily. Five years later, the recommended medication was changed to 300 mg of d-penicillamine four times a day, which

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