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Wilson's disease associated with pancreatitis
1Pediatric Gastroenterology and Nutrition Service, Soroka Medical Center, Beer-Sheva, Israel.
Insights
Wilson's disease can present with pancreatitis, a condition causing abdominal pain and pancreatic inflammation. This pancreatitis often improves with copper chelation therapy, such as D-penicillamine.
Area of Science:
- Hepatology
- Gastroenterology
- Pediatrics
Background:
- Wilson's disease is a genetic disorder of copper metabolism.
- Abdominal pain is a common presenting symptom in pediatric patients with Wilson's disease.
Observation:
- A 12-year-old boy presented with abdominal pain and distention, diagnosed with Wilson's disease.
- Pancreatitis was diagnosed concurrently, evidenced by elevated amylase and pancreatic ultrasonography findings.
Findings:
- D-penicillamine therapy led to resolution of abdominal pain and normalization of pancreatic function over 18 months.
- This suggests pancreatitis is a potential manifestation of Wilson's disease.
Implications:
- Pancreatitis should be considered in the differential diagnosis of abdominal pain in untreated Wilson's disease patients.
- Copper deposition in the pancreas may cause pancreatitis, responsive to chelation therapy.
Abstract:
A 12-year-old boy presented with a 2-month history of abdominal pain and distention. A diagnosis of Wilson's disease was established, and D-penicillamine therapy was initiated. An associated pancreatitis was diagnosed on presentation, based on elevated serum amylase and an enlarged pancreas ultrasonically. Subsequently, an 18-month follow-up disclosed no abdominal pain, with repeatedly normal serum amylase level and a normal pancreas on ultrasonography. Since abdominal pain is a common symptom in Wilson's disease on presentation, this possibility should be considered in untreated patients. It is concluded that pancreatitis may be associated with Wilson's disease, possibly because of copper deposition in the pancreas, and is probably responsive to copper chelation therapy.