A case of Wilson disease with the ATP7B mutation presenting movement disorders

Huong Van Nguyen; Diep Ngoc Nguyen; Huong Thi Nguyen

doi:10.25259/SNI_489_2021

A case of Wilson disease with the ATP7B mutation presenting movement disorders

Surg Neurol Int. 2021 Jun 28:12:303. doi: 10.25259/SNI_489_2021. eCollection 2021.

Authors

Huong Van Nguyen¹, Diep Ngoc Nguyen², Huong Thi Nguyen³

Affiliations

¹ Department of Neurology, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam.
² Institute of Theoretical and Applied Research, Duy Tan University, Da Nang, Vietnam.
³ Department of General Internal Medicine, Vinmec International Hospital, Hanoi, Vietnam.

Abstract

Background: Wilson disease is an autosomal recessive condition manifested when abnormal copper accumulation in the body particularly involving many organs such as brain, liver, and cornea. Diagnosis is challenging with the completion of tests in blood and urine, a liver biopsy, and clinical evaluation. ATP7B mutations with more than 600 identified variants are the genetic disorders of Wilson disease.

Case description: We report an adolescent case with no family history presented with extrapyramidal dyskinesia. Other symptoms include liver cirrhosis and Kayser-Fleischer ring. The typical presentation of blood test results and brain MRI images helps us to suspect Wilson disease in this case. We confirmed to have a p.R778L form and a p.S105X form in ATP7B mutations. After combining therapy with trihexyphenidyl and trientine, the patient's medical condition was stable and no side effects were observed.

Conclusion: Screening for the diagnosis of Wilson disease is essential in helping patients benefit from early treatment and genetic counseling.

Keywords: ATP7B; Movement disorders; Wilson disease; p.R778L; p.S105X.

Publication types

Case Reports