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Tjaard U. Hoogenraad, MD
Department of Neurology

Jan Van Hattum, MD
Department of Gastroenterology University Hospital 3500 CG Utrecht, the Netherlands

Arch Neurol. 1988;45(4):373-374.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The case history in the article by Brewer and coworkers¹ is another example of how dangerous it may be to start treatment with penicillamine in a patient with Wilson's disease and neurologic signs. Not infrequently the neurologic signs increase in the first weeks of treatment. It is our experience that a dramatic clinical recovery may occur after discontinuation of penicillamine therapy and institution of zinc therapy.^2-4 It is difficult to understand why Brewer and coworkers waited so long to switch over to zinc therapy in their patient. In 1983, they had already stated that the "European" experience with oral zinc sulfate provided some reassurance for the use of zinc in cases of penicillamine intolerance.⁵ In our opinion, it would have been better to start treatment with zinc in this patient.

In the Netherlands, zinc sulfate (200 to 300 mg three times a day) has . . . [Full Text PDF of this Article]

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