Oral Zinc Therapy for Wilson's Disease

Abstract

Wilson''s disease is an inherited disorder of Cu accumulation that is fatal if untreated. Because penicillamine, the established treatment, is toxic in a substantial number of patients, the efficacy of Zn treatment was studied. A negative or neutral Cu balance was induced in 5 out of 5 patients with Wilson''s disease who were receiving no therapy other than Zn. Zn acetate was given every 4 h during the day, and the patient was not allowed to eat for 1 h before and 1 h after each dose. Oral Zn therapy, used according to this regimen, may now be considered in the treatment of patients with penicillamine intolerance. It is premature to convert patients to Zn therapy if they tolerate penicillamine well. The efficacy of Zn therapy in the initial removal of the Cu burden in acutely ill patients with Wilson''s disease has not yet been evaluated.