Monitoring
Monitoring of therapy, compliance, and medication 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 inquire about any new neurologic and psychiatric symptoms, and any new medications. Physical examination should focus on signs of liver disease and neurologic 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 medication. Patients on chelation therapy should have their urine and CBC with differential tested for medication-related complications.[5]
Screening and surveillance for hepatocellular carcinoma is recommended for patients with Wilson disease with cirrhosis.[5] See Hepatocellular carcinoma.
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