Monitoring
Monitoring of therapy, compliance, and medicine adverse effects is indicated in all patients; however, frequency of follow-up depends on the individual. At a minimum, each patient should be monitored every 6 months.[5] On history the physician should enquire about any new neurological and psychiatric symptoms, and any new medications. Physical examination should focus on signs of liver disease and neurological disease.
Regular blood tests include liver function tests, serum copper, and ceruloplasmin. Measurement of 24-hour urinary copper and zinc excretion is useful in testing for the patient's compliance with medicine. Patients on chelation therapy should have their urine and FBC with differential tested for medicine-related complications.[5]
Screening and surveillance for hepatocellular carcinoma is recommended for patients with Wilson's disease with cirrhosis.[5] See Hepatocellular carcinoma.
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