Mark B. Skeen, MD
To the Editors: The review by Stremmel and colleagues (1) is informative and provides a significant analysis of the presentation, evaluation, and long-term course of Wilson disease using current therapies. Their conclusion that the calculated serum free-copper concentration is the most reliable finding for the initial diagnosis and is the best indicator of the effectiveness of copper-reducing therapy is noteworthy. Of specific interest is the significantly reduced incidence of severe side effects of D-penicillamine compared with the incidence reported in previous studies of its use in rheumatoid arthritis, systemic sclerosis, and primary biliary cirrhosis. Current package labeling states "Because of
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Skeen MB. Wilson Disease—Penicillamine Therapy and Late Presentation. Ann Intern Med. 1992;116:424–425. doi: 10.7326/0003-4819-116-5-424_2
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Published: Ann Intern Med. 1992;116(5):424-425.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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