Clinical and genetic heterogeneity in Wilson disease - A review
Journal Title: Journal of Medical and Scientific Research - Year 2015, Vol 3, Issue 4
Abstract
Wilson disease (WD) is an inborn error of copper metabolism leading to its accumulation in liver, kidney and cornea. It is caused by a defective ATPase protein which is coded by ATP7B gene. It follows an autosomal recessive mode of inheritance with a prevalence of 1 in 30,000. WD shows varied clinical heterogeneity making clinical diagnosis a difficult task. The corneal Kayser-Fleischer (KF) ring is an important diagnostic criterion as it is invariably present in 95% of the WD cases. In this review, we discussed the varied clinical manifestations of WD which makes diagnosis a challenging process. Though genetic testing is a reliable technique to confirm clinical diagnosis, genotype-phenotype correlations are yet to be established. This could be attributed to the consanguinity and ethnic variation observed in the Indian population, suggesting genetic heterogeneity leading to clinical heterogeneity making diagnosis difficult. Further, genetic studies are warranted to establish genotype-phenotype correlations which can pave way for early diagnosis and treatment. Genetic testing will help in identifying pre-symptomatic siblings and other family members of the patient who should be advised for regular follow-up. A combination of clinical and genetic studies should be considered for proper understanding of disease manifestation and for making an early clinical diagnosis of WD.
Authors and Affiliations
Rangaraju A, Sridhar MS, Poonam N
Spontaneous transanal externalization of ventriculoperitoneal shunt
Aim of this paper is to report a case of spontaneous externalization of Ventriculoperitoneal shunt tube through anus in an eighteen months female child (k/c/o Dandy-Walker malformation) treated with placement of ventricu...
Primary Sjogren syndrome with diffuse alveolar hemorrhage, cryoglobulinaemia and thrombotic microangiopathy
Sjogren syndrome is an autoimmune exocrinopathy with various extra glandular manifestations. Cryoglobulinemia, small vessel vasculitis has been reported in 5-10% of patients with primary Sjogren syndrome. It may be assoc...
Suprasellar colloid cyst: An unusual location
Background: Colloid cysts are rare intracerebral lesions that are preferentially encountered within the third ventricle. There are only a few reports in which colloid cysts are described in other locations such as the fo...
Microfluidics for antibody-independent separation of circulating tumor cells
Separation of circulating tumor cells (CTC) from the blood without using antibodies is a key challenge in the diagnosis of cancer. This article has reviewed few antibody-independent techniques governed by cell size on mi...
Screening and prevention of cervical cancers
Cervical cancer in India ranks as the 2nd most frequent cancer among women and the 2nd most frequent cancer among women between 15 and 44 years of age. As per National Cancer Registry, crude incidence and mortality rate...