Wilson’s disease in children: Recent update on pathophysiology and management

Table 1 Clinical features of Wilson’s disease

Hepatic	Neurologic	Psychiatric	Eye	Hematologic	Renal	Skin	Osteoarticular	Endocrine	Reproductive system
Asymptomatic increased serum transaminases. Acute hepatitis. Hepatomegaly. Fatty liver. Acute liver failure with hemolysis. Portal hypertension. Decompensated cirrhosis with ascites	Deterioration of handwriting school performance. Dysarthria. Drooling, hypersalivation. Tremor. Dystonia. Coordination defect. Choreoathetosis. Ataxic gait. Fixed grin seizure	Organic dementia. Depression, anxiety. Psychosis. Behavioral changes. Emotional lability. Schizophrenia. Bipolar disorder. Obsessive- compulsive disorder. Antisocial behavior	Kayser-Fleischer ring. Sunflower cataract	Acute hemolytic anemia	Tubular dysfunction. Nephrolithiasis. Nephrocalcinosis. Hypercalciuria. Hyperphosphaturia	Hyperpigmentation. Azure lunulae of nails. Acanthosis nigricans	Osteoporosis. Rickets. Osteomalacia. Pathological fracture	Glucose intolerance. Hypoparathyroidism. Panhypopituitarism	Menstrual irregularity. Delayed puberty. Infertility. Miscarriage