Wilson's disease physical examination: Difference between revisions

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Latest revision as of 19:26, 29 August 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

Patients with Wilson's disease usually appear tired. Physical examination of patients with Wilson's disease is usually remarkable for jaundice and easy bruising in the skin. Physical examination also is remarkable for Kayser-Fleischer ring in the eyes as a result of the copper accumulation in the cornea. Common physical examination findings in the abdomen include abdominal tenderness, ascites, and spider angiomata. Common neuropsychiatric signs include seizures, parkinsonism like signs, depression, and anxiety.

Physical examination

Appearance of the patient

Patients with Wilson's disease mostly appear tired due to the hepatic involvement.

Vitals

Low blood pressure
Hypothermia / hyperthermia may be present

Skin

HEENT

Icteric sclera
Kayser-Fleischer ring in the eyes

Abdomen

Abdominal tenderness
Hepatosplenomegaly
Ascites
Spider angiomata (in cases with cirrhosis)
Esophageal varices

Heart

Neuromuscular

Neurologic manifestations of Wilson's disease include the following:^[1]
- Parkinsonism like signs such as:
  - Bradykinesia
  - Cogwheel rigidity
  - Lack of balance
- Seizures
- Migrane
- Frontal lobe disorder with the following signs:
  - Impaired judgement
  - Apathy
  - Poor planning
- Psychiatric features such as:

References

↑ Lorincz MT (2010). "Neurologic Wilson's disease". Ann N Y Acad Sci. 1184: 173–87. doi:10.1111/j.1749-6632.2009.05109.x. PMID 20146697.

[pmid20146697-1] Lorincz MT (2010). "Neurologic Wilson's disease". Ann N Y Acad Sci. 1184: 173–87. doi:10.1111/j.1749-6632.2009.05109.x. PMID 20146697.

[1]

@@ Line 2: / Line 2: @@
 {{Template:Wilson's disease}}
 {{CMG}}; {{AE}} {{AEL}}
 ==Overview==
-==Physical examination==
+Patients with Wilson's disease usually appear [[tired]]. Physical examination of patients with Wilson's disease is usually remarkable for [[jaundice]] and [[easy bruising]] in the [[skin]]. Physical examination also is remarkable for [[Kayser-Fleischer ring]] in the [[eyes]] as a result of the [[copper]] accumulation in the [[cornea]]. Common physical examination findings in the [[abdomen]] include [[abdominal tenderness]], [[ascites]], and [[spider angiomata]]. Common [[neuropsychiatric]] signs include [[seizures]], [[parkinsonism]] like signs, [[depression]], and [[anxiety]].
+==Physical examination==
+=== Appearance of the patient ===
+* Patients with Wilson's disease mostly appear [[tired]] due to the [[hepatic]] involvement.
+=== Vitals ===
+* [[Low blood pressure]]
+* [[Hypothermia]] / [[hyperthermia]] may be present
+=== Skin ===
+* [[Jaundice]]
+* [[Easy bruising]] ([[bleeding tendency]])
+=== HEENT ===
+* [[Icterus|Icteric sclera]]
+* [[Kayser-Fleischer ring]] in the [[eyes]]
+=== Abdomen ===
+* [[Abdominal tenderness]]
+* [[Hepatosplenomegaly]]
+* [[Ascites]]
+* [[Spider angiomata]] (in cases with [[cirrhosis]])
+* [[Esophageal varices]]
+=== Heart ===
+* [[Cardiomyopathy]]
+* [[Cardiac arrhythmia]]
+=== Neuromuscular ===
+* [[Neurology|Neurologic]] manifestations of Wilson's disease include the following:<ref name="pmid20146697">{{cite journal| author=Lorincz MT| title=Neurologic Wilson's disease. | journal=Ann N Y Acad Sci | year= 2010 | volume= 1184 | issue=  | pages= 173-87 | pmid=20146697 | doi=10.1111/j.1749-6632.2009.05109.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20146697  }}</ref>
+** [[Parkinsonism]] like signs such as:
+*** [[Bradykinesia]]
+*** Cogwheel rigidity
+*** Lack of balance
+** [[Seizures]]
+** [[Migrane]]
+** [[Frontal lobe]] disorder with the following signs:
+*** Impaired judgement
+*** [[Apathy]]
+*** Poor planning
+** [[Psychiatric]] features such as:
+*** [[Depression]]
+*** [[Psychosis]]
+*** [[Anxiety]]
 ==References==
 {{reflist|2}}
+[[Category:Gastroenterology]]
+[[Category:Hematology]]
+[[Category:Medicine]]
+[[Category:Up-To-Date]]