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Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 54
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3
rd
International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13
th
International Conference on
&
To study the efficacy of Penicillamine followed by Zinc in treating symptomatic predominantly
hepatic WD.
Piyush Gupta
Christian Medical College Hospital, India
Background:
Experience with Zinc in treating symptomatic hepatic Wilson’s disease (WD) is limited.
Methods:
We studied symptomatic WD patients in whom Penicillamine was changed to Zinc sulfate either due to financial
constraints (in 25 patients) or due to adverse effects of Penicillamine (in 2). Disease severity scores (Child’s, MELD, Nazer’s
and NewWilson Index score) and 24-hour Urinary copper were calculated at 3 time points – baseline at diagnosis, at transition
from Penicillamine to Zinc and at end of follow-up.
Results:
27patientswere studied, 18hadhepaticWD, 8hadneurological andhepaticWDand1hadhepatic andneuropsychiatric
manifestations. Child’s grade was A in 6 patients, B in 3 and C in 15. Duration of Initial Penicillamine chelation therapy was
132 weeks (range: 2-320), and of subsequent Zinc therapy was 366 weeks (range 35-728). Three patients died at 284,112 and
437 weeks. No patient underwent liver transplantation. There was significant improvement in liver function tests and disease
severity scores (Nazer’s score, New Wilson index score, Child’s and MELD score) at transition from Penicillamine to Zinc
compared to baseline which was maintained till end of study period. Nine patients had received Penicillamine for less than 1
year (35 weeks; range: 2-52) and 15 patients had decompensated cirrhosis with Child Grade-C at presentation who improved
until end of follow-up.
Conclusions:
Penicillamine followed by Zinc maybe a safe and effective treatment in resource constrained setting for
symptomatic (predominantly) hepaticWD patients with all grades of baseline disease severity. Our data also shows that patients
with decompensated cirrhosis due to wilson’s disease can be managed with medical treatment avoiding liver transplantation.
docpiyushgupta@gmail.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083