Research is ongoing and general population screening is not available. Measurement of ceruloplasmin using dried blood spots in newborns, or urine in children, is under investigation.[37]Owada M, Suzuki K, Fukushi M, et al. Mass screening for Wilson's disease by measuring urinary holoceruloplasmin. J Pediatr. 2002 May;140(5):614-6.
http://www.ncbi.nlm.nih.gov/pubmed/12032531?tool=bestpractice.com
[38]Aoki K. Newborn screening in Japan. Southeast Asian J Trop Med Public Health. 2003;34 Suppl 3:80.
http://www.ncbi.nlm.nih.gov/pubmed/15906702?tool=bestpractice.com
[39]Kroll CA, Ferber MJ, Dawson BD, et al. Retrospective determination of ceruloplasmin in newborn screening blood spots of patients with Wilson disease. Mol Genet Metab. 2006 Sep-Oct;89(1-2):134-8.
http://www.ncbi.nlm.nih.gov/pubmed/16644258?tool=bestpractice.com
First-degree relatives of any patient newly diagnosed with Wilson's disease must be screened for Wilson's disease.[5]Schilsky ML, Roberts EA, Bronstein JM, et al. A multidisciplinary approach to the diagnosis and management of Wilson disease: executive summary of the 2022 practice guidance on Wilson disease from the American Association for the Study of Liver Diseases. Hepatology. 2023 Apr 1;77(4):1428-55.
https://journals.lww.com/hep/fulltext/2023/04000/a_multidisciplinary_approach_to_the_diagnosis_and.32.aspx
http://www.ncbi.nlm.nih.gov/pubmed/36152019?tool=bestpractice.com
[24]Shribman S, Marjot T, Sharif A, et al; British Association for the Study of the Liver Rare Diseases Special Interest Group. Investigation and management of Wilson's disease: a practical guide from the British Association for the Study of the Liver. Lancet Gastroenterol Hepatol. 2022 Jun;7(6):560-75.
http://www.ncbi.nlm.nih.gov/pubmed/35429442?tool=bestpractice.com
[25]Socha P, Janczyk W, Dhawan A, et al. Wilson's disease in children: a position paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018 Feb;66(2):334-44.
https://journals.lww.com/jpgn/Fulltext/2018/02000/Wilson_s_Disease_in_Children__A_Position_Paper_by.32.aspx
http://www.ncbi.nlm.nih.gov/pubmed/29341979?tool=bestpractice.com
[40]Reau N, Munoz SJ, Schiano T. Liver disease during pregnancy. Am J Gastroenterol. 2022 Oct 1;117(10s):44-52.
https://journals.lww.com/ajg/fulltext/2022/10001/liver_disease_during_pregnancy.8.aspx
http://www.ncbi.nlm.nih.gov/pubmed/36194033?tool=bestpractice.com
Obtain a clinical history from the relative, including symptoms of jaundice, history of liver disease, and any neurological or psychiatric symptoms. A physical examination should be conducted evaluating hepatic disease stigmata, peripheral and central nervous system functioning, and Kayser-Fleischer (KF) rings.
Screening investigations for first-degree relatives of a diagnosed patient include:[5]Schilsky ML, Roberts EA, Bronstein JM, et al. A multidisciplinary approach to the diagnosis and management of Wilson disease: executive summary of the 2022 practice guidance on Wilson disease from the American Association for the Study of Liver Diseases. Hepatology. 2023 Apr 1;77(4):1428-55.
https://journals.lww.com/hep/fulltext/2023/04000/a_multidisciplinary_approach_to_the_diagnosis_and.32.aspx
http://www.ncbi.nlm.nih.gov/pubmed/36152019?tool=bestpractice.com
[24]Shribman S, Marjot T, Sharif A, et al; British Association for the Study of the Liver Rare Diseases Special Interest Group. Investigation and management of Wilson's disease: a practical guide from the British Association for the Study of the Liver. Lancet Gastroenterol Hepatol. 2022 Jun;7(6):560-75.
http://www.ncbi.nlm.nih.gov/pubmed/35429442?tool=bestpractice.com
[25]Socha P, Janczyk W, Dhawan A, et al. Wilson's disease in children: a position paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018 Feb;66(2):334-44.
https://journals.lww.com/jpgn/Fulltext/2018/02000/Wilson_s_Disease_in_Children__A_Position_Paper_by.32.aspx
http://www.ncbi.nlm.nih.gov/pubmed/29341979?tool=bestpractice.com
Molecular testing for ATP7B mutations or haplotype studies: may be used as primary screening if available
Liver function tests, serum ceruloplasmin, and serum copper
24-hour urinary copper excretion
Slit-lamp examination for KF rings
Liver biopsy.