Wilson's disease physical examination

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

Physical examination

Appearance of the patient

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

Vitals

• Low blood pressure may be present in shock liver.
• Hypothermia / hyperthermia may be present.

Skin

• Jaundice
• Easy bruising (bleeding tendency)

HEENT

• 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

• 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