• Shinji Oe, Yuichi Honma, Kei Yabuki, Kahori Morino, Keiichiro Kumamoto, Tsuguru Hayashi, Masashi Kusanaga, Noriyoshi Ogino, Sota Minami, Michihiko Shibata, Shintaro Abe, and Masaru Harada.
• Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
• Intern. Med. 2020 Jan 1; 59 (1): 77-81.

AbstractA 37-year-old Wilson disease patient treated with D-penicillamine visited our hospital for the evaluation of his liver function. Laboratory data showed a low serum copper level and ceruloplasmin. The ratio of urinary copper to urinary creatinine in a spot urinary analysis after 4 days' cessation of D-penicillamine was under 0.1. We concluded that the copper chelation was excessive and changed D-penicillamine to zinc acetate. However, his liver function test results did not normalize. We performed a liver biopsy and discovered a high copper content. The liver dysfunction was improved after resuming chelating therapy. Accurate measurement of the hepatic copper content via a biopsy is important for the adequate management of this disease.

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