Wilson's disease. Development of neurological disease after beginning penicillamine therapy
J. D. Glass, S. G. Reich and M. R. DeLong
Department of Neurology, Johns Hopkins Hospital, Baltimore, Md 21205.
Patients with neurological symptoms and signs of Wilson's disease have been
frequently noted to have a worsening of their condition after beginning
chelation therapy with D-penicillamine. Presymptomatic patients, however,
are not expected to develop neurological manifestations once appropriate
therapy is begun. We describe a patient who was seen with hepatic disease
and no neurological symptoms who became neurologically incapacitated soon
after beginning penicillamine therapy. This case identifies an unexpected
complication of penicillamine therapy that should be watched for in the
presymptomatic patient who is beginning therapy.
