Korean J Obstet Gynecol.  2012 Mar;55(3):180-182. 10.5468/KJOG.2012.55.3.180.

Pregnancy in a woman with Wilson's disease treated with zinc: A case report

Affiliations
  • 1Department of Gynaecology and Obstetrics, North Bengal Medical College, Darjeeling, West Bengal, India. sanjay.krbhattacharyya@gmail.com
  • 2Department of General Medicine, North Bengal Medical College, Darjeeling, West Bengal, India.

Abstract

Wilson's disease is a rare hereditary disorder of copper metabolism affecting 30 per million populations. Copper get deposited in liver, brain and kidney due to decreased hepato-cellular excretion and leading to diverse clinical manifestations. Patient may remain apparently asymptomatic or may present with fulminant liver disease or neuropsychiatric illness. Reproductive outcome in untreated Wilson's disease is poor. Women remaining untreated either suffer from infertility or experience recurrent pregnancy losses. Invention of copper chelating agents and their usage in these women resulted in successful pregnancy outcome. Penicillamine or zinc salts can be used as copper chelator in pregnancy with Wilson's disease with equal effectiveness in respect to pregnancy outcome. We report a case of previously undiagnosed Wilson's disease with three consecutive pregnancy losses who achieved a live birth after successfully treated with zinc salts. The several points regarding antenatal care, drug therapy and optimum time and mode of delivery for the woman with Wilson's disease are discussed here.

Keyword

Penicillamine; Wilson's disease; Zinc

MeSH Terms

Brain
Chelating Agents
Copper
Female
Hepatolenticular Degeneration
Humans
Infertility
Inventions
Kidney
Live Birth
Liver
Liver Diseases
Penicillamine
Pregnancy
Pregnancy Outcome
Salts
Zinc
Chelating Agents
Copper
Penicillamine
Salts
Zinc

Reference

1. Roberts EA, Schilsky ML. American Association for Study of Liver Diseases (AASLD). Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008. 47:2089–2111.
2. Sinha S, Taly AB, Prashanth LK, Arunodaya GR, Swamy HS. Successful pregnancies and abortions in symptomatic and asymptomatic Wilson's disease. J Neurol Sci. 2004. 217:37–40.
3. Brewer GJ, Johnson VD, Dick RD, Hedera P, Fink JK, Kluin KJ. Treatment of Wilson's disease with zinc. XVII: treatment during pregnancy. Hepatology. 2000. 31:364–370.
4. Scheinberg IH, Sternlieb I. Pregnancy in penicillamine-treated patients with Wilson's disease. N Engl J Med. 1975. 293:1300–1302.
5. Kroll CA, Ferber MJ, Dawson BD, Jacobson RM, Mensink KA, Lorey F, et al. Retrospective determination of ceruloplasmin in newborn screening blood spots of patients with Wilson disease. Mol Genet Metab. 2006. 89:134–138.
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