Chronic Hepatitis As a First Manifestation of Wilson's Disease

In four males and three females, from 12 to 28 years of age, chronic hepatitis was diagnosed because of manifestations indistinguishable from those generally associated with this disease. From 3 months to 4½ years after the onset of hepatic illness, persistence of the hepatic disorder for 4 years in one boy, a diagnosis of Wilson's disease in one girl's sibling, the development of neurologic symptoms in four of these patients, and the accidental discovery of Kayser-Fleischer rings in a man led to the suspicion of Wilson's disease in each of the seven patients. Although copper toxicity is etiologic in probably no more than 5% of patients with chronic hepatitis, it is susceptible to specific and effective pharmacologic therapy, unlike most other forms of hepatitis. Consequently, the disease should be borne in mind and the concentration of ceruloplasmin in serum measured in every child or young adult under 30 years of age with idiopathic chronic hepatitis.