Diagnosing Wilson Disease A High Index Of Suspicion

excretion is a useful marker in monitoring pharmaco-therapy and compliance.

Liver biopsy with determination of hepatic copper content is the most valuable single diagnostic procedure. Liver copper >250 pg/g dry weight is highly suggestive for Wilson disease, but may be also found in cholestatic diseases and in idiopathic copper toxicosis. The major shortcoming of a single liver biopsy specimen is underestimation of hepatic copper because of inhomogeneous copper deposition in the liver. Detection of copper in histological specimens by special staining methods such as rhodamine or orcein staining depends on its intracel-lular localization and is therefore insensitive and rarely helpful in establishing diagnosis. The histological findings in Wilson disease may resemble the features of various other liver disorders such as autoimmune hepatitis or nonalcoholic steatohepatitis.

Neuropsychiatric examination is required in every patient with Wilson disease and magnetic resonance imaging (MRI) should be performed in patients presenting with neurological manifestations.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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