Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
  • Home
  • about
  • archives
  • contacts
left
FULLSCREEN > Archive > 2025 > Vol 6, №5 (2025) > Diagnostics of Wilson–Konovalov disease under the mask of alpha-1-antitrypsin deficiency in pediatric practice: a clinical case and a literature review

Diagnostics of Wilson–Konovalov disease under the mask of alpha-1-antitrypsin deficiency in pediatric practice: a clinical case and a literature review

Vitaly V. Gorban , Olesya V. Pervishko , Pavel L. Levin , Violetta N. Firsova , Elina A. Arutyunyan

For citation:


  • Abstract
  • About the Author
  • References

Abstract

Wilson's disease (WD) is an autosomal recessive neurometabolic disorder associated with the buildup of copper in the body and gradual organ degeneration. It results from mutations in the ATP7B gene. The diagnosis and treatment of this potentially curable disease have changed significantly since WD was described more than a century ago. However, early diagnosis of WD remains a medical challenge. Probably, this is due to the fact that it is rare, especially at the level of primary care provision. That is why the key task is to encourage physicians to thoroughly detect atypical or implicit signs of WD, especially in pediatric practice. The paper provides a clinical case of WD in a child followed-up for 5 years and showing concomitant alpha-1-antitrypsin deficit, symptoms of dyspepsia, liver damage with the phenomena of cytolisis and mild jaundice. The ceruloplasmin and copper excretion levels were of little weight. Thorough comprehensive diagnosis involving a multidisciplinary team of physicians and including the specialized imaging methods and genetic testing revealed the signs that were rare, but typical for Wilson's disease, the early diagnosis of which improves the outcome.
Keywords: children, Wilson–Konovalov disease, alpha-1-antitrypsin, copper, gene ATP7B.

About the Author

Vitaly V. Gorban , Olesya V. Pervishko , Pavel L. Levin , Violetta N. Firsova , Elina A. Arutyunyan
Vitaly V. Gorban, Olesya V. Pervishko, Pavel L. Levin, Violetta N. Firsova, Elina A. Arutyunyan 

Kuban State Medical University, Krasnodar, Russia 
gorbanvv@mail.ru

References

1. Нарушения обмена меди (болезнь Вильсона): клинические рекомендации. 2021. Режим доступа: https://cr.minzdrav.gov.ru/recomend/376_2
Copper Metabolism Disorders (Wilson's Disease): Clinical Guidelines. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/376_2 (in Russian).
2. Рейзис А.Р. Болезнь Вильсона–Коновалова у детей. Доктор.Ру. 2020;19(10):52-6. DOI: 10.31550/1727-2378-2020-19-10-52-56
Reizis A.R. Wilson–Konovalov disease in children. Doctor.Ru. 2020;19(10):52-6. DOI: 10.31550/1727-2378-2020-19-10-52-56 (in Russian).
3. Członkowska A, Litwin T, Dusek P et al. Wilson disease. Nat Rev Dis Primers. 2018;(4):21. DOI: 10.1038/s41572-018-0018-3
4. Teschke R, Eickhoff A. Wilson Disease: Copper-Mediated Cuproptosis, Iron-Related Ferroptosis, and Clinical Highlights, with Comprehensive and Critical Analysis Update. Int J Mol Sci 2024;(25):4753. DOI: 10.3390/ ijms25094753
5. Nagappa M, Sinha S, Saini JS et al. Non-Wilsonian hepatolenticular degeneration: clinical and MRI observations in four families from south India. J Clin Neurosci 2016;(27):91-4. DOI: 10.1016/j.jocn.2015.06.035
6. Ungureanu IM, Iesanu MI, Boboc C et al. Addressing the Challenges in the Diagnosis and Management of Pediatric Wilson’s Disease – Case Report and Literature Review. Medicina 2023;(59):786. DOI: 10.3390/medicina59040786
7. Рыжкова О.В., Козлова Н.М., Филатова И.А., Синицына Т.А. Поздняя диагностика болезни Вильсона–Коновалова (клинический случай). Дневник Казанской медицинской школы. 2020;4(30):30-3.
Ryzhkova O.V., Kozlova N.M., Filatova I.A., Sinitsyna T.A. Late diagnosis of Wilson-Konovalov disease (clinical case). Diary of the Kazan Medical School. 2020;4(30):30-3 (in Russian).
8. Вологжанина Л.Г., Петухова И.В., Щербинина Е.А., Шиляева Н.А. Тромбоцитопеническая «маска» болезни Вильсона–Коновалова. Гастроэнтерология Санкт-Петербурга. 2018;(4):31-5.
Vologzhanina L.G., Petukhova I.V., Shcherbinina E.A., Shilyaeva N.A. Thrombocytopenic “mask” of Wilson-Konovalov disease. Gastroenterology of St. Petersburg. 2018;(4):31-5 (in Russian).
9. Базилевич С.Н., Прокудин М.Ю., Дыскин Д.Е. Болезнь Вильсона–Коновалова и эпилепсия. Вестник Российской военно-медицинской академии. 2018;(3):13-8.
Bazilevich S.N., Prokudin M.Yu., Dyskin D.E. Wilson-Konovalov disease and epilepsy. Bulletin of the Russian Military Medical Academy. 2018;(3):13-8 (in Russian).
10. European Association for Study of Liver. EASL Clinical Practice Guidelines: Wilson's disease. J Hepatol 2012;56(3):671-85. DOI: 10.1016/j.jhep.2011.11.007
11. Gromadzka G, Czerwinska J, Krzeminska E et al. Wilson’s Disease – Crossroads of Genetics, Inflammation and Immunity/Autoimmunity: Clinical and Molecular Issues. Int J Mol Sci 2024;(25):9034. DOI: 10.3390/ijms25169034
12. Wiecek S, Paprocka J. Disorders of Copper Metabolism in Children – A Problem too Rarely Recognized. Metabolites 2024;(14):38. DOI: 10.3390/ metabo14010038
13. 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;66(2):334-44. DOI: 10.1097/MPG. 0000000000001787
14. Хавкин А.И., Волынец Г.В., Панфилова В.Н. и др. Нарушение структуры и функции печени при болезни Вильсона у детей: современное состояние проблемы. Экспериментальная и клиническая гастроэнтерология. 2017;7(143):192-9.
Khavkin A.I., Volynets G.V., Panfilova V.N. et al. Impaired liver structure and function in children with Wilson's disease: current state of the problem. Experimental and clinical gastroenterology. 2017;7(143): 192-9 (in Russian).
15. Травенко Е.Н., Породенко В.А., Носкова У.А. и др. Патология печени в структуре причин смерти от заболеваний желудочно-кишечного тракта в Краснодарском крае в 2014–2018 годах. Кубанский научный медицинский вестник. 2020;27(2):102-12. DOI: 10.25207/1608-6228-2020-27-2-102-112
Travenko E.N., Porodenko V.A., Noskova U.A., et al. Liver pathology in the structure of causes of death from gastrointestinal diseases in the Krasnodar Territory in 2014–2018. Kuban Scientific Medical Bulletin. 2020; 27(2):102–12. DOI: 10.25207/1608-6228-2020-27-2-102-112 (in Russian).
16. Saroli PC, Schilsky ML. Clinical practice guidelines in Wilson disease. Ann Transl Med 2019;7(2):65. DOI: 10.21037/atm.2018.12.53
17. Aggarwal A, Bhatt M. Wilson disease. Curr Opin Neurol 2020;33(4):534-42. DOI: 10.1097/WCO.0000000000000837
18. Salman HM, Amin M, Syed J et al. Biochemical testing for the diagnosis of Wilson's disease: A systematic review. J Clin Lab Anal 2021;36(2):e24191. DOI: 10.1002/jcla.24191
19. Тулузановская И.Г., Жученко Н.А., Балашова М.С. и др. Болезнь Вильсона–Коновалова: внутрисемейный клинический полиморфизм. Педиатрия. Журнал им. Г.Н. Сперанского. 2017;96(6):215-6. DOI: 10.24110/0031-403X-2017-96-6-215-216
Tuluzanovskaya I.G., Zhuchenko N.A., Balashova M.S. et al. Wilson–Konovalov disease: familial clinical polymorphism. Pediatrics.
G.N. Speransky Journal. 2017;96(6):215-6. DOI: 10.24110/0031-403X-2017-96-6-215-216 (in Russian).
20. Lu X, Li S, Zhang W et al. Assessment of the diagnostic value of serum ceruloplasmin for Wilson’s disease in children. BMC Gastroenterology 2022;(22):124. DOI: 10.1186/s12876-022-02186-0
21. Litwin T. Wilson's disease – An early diagnosis to improve outcomes. LETTER TO THE EDITOR. United European Gastroenterol J 2023;(11):1024-5. DOI: 10.1002/ueg2.12481
22. Ovchinnikova E.V., Garbuz M.M., Ovchinnikova A.A., Kumeiko V.V. Epidemiology of Wilson’s Disease and Pathogenic Variants of the ATP7B Gene Leading to Diversified Protein Disfunctions. Int J Mol Sci 2024;(25):2402. DOI: 10.3390/ijms25042402
23. Dong Y, Wu Z-Y. Challenges and suggestions for precise diagnosis and treatment of Wilson’s disease. World J Pediatr 2021;(17):561-5. DOI: 10.1007/s12519-021-00475-4
24. 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;(77):1428-55. DOI: 10.1002/hep.32805
25. Wang J, Tang L, Xu A et al. Identification of mutations in the ATP7B gene in 14 Wilson disease children: Case series. Medicine 2021;(100):16(e25463). DOI: 10.1097/MD.0000000000025463
26. Garbuz MM, Ovchinnikova AA, Kumeiko VV. Design, Optimization and Validation of the ARMS PCR Protocol for the Rapid Diagnosis of Wilson’s Disease Using a Panel of 14 Common Pathogenic variants for the European Population. Genes 2022;(13):1940. DOI: 10.3390/genes13111940
27. Woimant F, Poujois A, Bloch A et al. A novel deep intronic variant in ATP7B in five unrelated families affected by Wilson disease. Mol Genet Genom Med 2020;(8):e1428. DOI: 10.1002/mgg3.1428
28. Самодова О.В., Смирнова Г.П., Кригер Е.А. Болезнь Вильсона–Коновалова в практике педиатра: клинические наблюдения с разными вариантами течения и исхода. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2023;33(1): 77-83. DOI: 10.22416/1382-4376-2023-33-1-77-83
Samodova O.V., Smirnova G.P., Kriger E.A. Wilson-Konovalov disease in pediatric practice: clinical observations with different variants of the course and outcome. Russian Journal of Gastroenterology, Hepatology, Proctology. 2023;33(1):77-83. DOI: 10.22416/1382-4376-2023-33-1-77-83 (in Russian).
29. Vidhusree D, Krithika AP. Wilson’s Disease in Childhood and the Challenges in Its Diagnosis: A Case Report. Cureus 2024;16(7):e65847. DOI: 10.7759/cureus.65847

Портал CON-MED.RU:
https://con-med.ru/magazines/klinicheskiy_razbor_v_obshchey_meditsine/klinicheskiy_razbor_v_obshchey_meditsine-05-2025/diagnostika_bolezni_vilsona_konovalova_pod_maskoy_defitsita_alfa_1_antitripsina_v_pediatricheskoy_pr/

For citation: Gorban V.V., Pervishko O.V., Levin P.V., Firsova V.N., Arutyunyan E.A. Diagnostics of Wilson–Konovalov disease under the mask of alpha-1-antitrypsin deficiency in pediatric practice: a clinical case and a literature review. Clinical review for general practice. 2025; 6 (5): 100–106 (In Russ.). DOI: 10.47407/kr2025.6.5.00619


All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

  • About
  • Editorial board
  • Ethics
  • For authors
  • Author fees
  • Peer review
  • Contacts

oa
crossref
анри


  Indexing

Scopus
doaj
elibrary

Address of the Editorial Office:

127055, Moscow, s/m 37

Correspondence address:

115054, Moscow, Zhukov passage, 19, fl. 2, room XI


Managing Editor:

+7 (495) 926-29-83

id@con-med.ru