Screening for Wilson disease in acute liver failure: A comparison of currently available diagnostic tests Potential conflict of interest: Nothing to report.
dc.contributor.author | Korman, Jessica D. | en_US |
dc.contributor.author | Volenberg, Irene | en_US |
dc.contributor.author | Balko, Jody | en_US |
dc.contributor.author | Webster, Joe | en_US |
dc.contributor.author | Schiodt, Frank V. | en_US |
dc.contributor.author | Squires, Robert H. | en_US |
dc.contributor.author | Fontana, Robert John | en_US |
dc.contributor.author | Lee, William M. | en_US |
dc.contributor.author | Schilsky, Michael L. | en_US |
dc.date.accessioned | 2008-11-03T18:52:19Z | |
dc.date.available | 2009-11-06T18:12:56Z | en_US |
dc.date.issued | 2008-10 | en_US |
dc.identifier.citation | Korman, Jessica D.; Volenberg, Irene; Balko, Jody; Webster, Joe; Schiodt, Frank V.; Squires, Robert H.; Fontana, Robert J.; Lee, William M.; Schilsky, Michael L. (2008). "Screening for Wilson disease in acute liver failure: A comparison of currently available diagnostic tests Potential conflict of interest: Nothing to report. ." Hepatology 48(4): 1167-1174. <http://hdl.handle.net/2027.42/61205> | en_US |
dc.identifier.issn | 0270-9139 | en_US |
dc.identifier.issn | 1527-3350 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/61205 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=18798336&dopt=citation | en_US |
dc.description.abstract | Acute liver failure (ALF) due to Wilson disease (WD) is invariably fatal without emergency liver transplantation. Therefore, rapid diagnosis of WD should aid prompt transplant listing. To identify the best method for diagnosis of ALF due to WD (ALF-WD), data and serum were collected from 140 ALF patients (16 with WD), 29 with other chronic liver diseases and 17 with treated chronic WD. Ceruloplasmin (Cp) was measured by both oxidase activity and nephelometry and serum copper levels by atomic absorption spectroscopy. In patients with ALF, a serum Cp <20 mg/dL by the oxidase method provided a diagnostic sensitivity of 21% and specificity of 84% while, by nephelometry, a sensitivity of 56% and specificity of 63%. Serum copper levels exceeded 200 Μg/dL in all ALF-WD patients measured (13/16), but were also elevated in non-WD ALF. An alkaline phosphatase (AP) to total bilirubin (TB) ratio <4 yielded a sensitivity of 94%, specificity of 96%, and a likelihood ratio of 23 for diagnosing fulminant WD. In addition, an AST:ALT ratio >2.2 yielded a sensitivity of 94%, a specificity of 86%, and a likelihood ratio of 7 for diagnosing fulminant WD. Combining the tests provided a diagnostic sensitivity and specificity of 100%. Conclusion: Conventional WD testing utilizing serum ceruloplasmin and/or serum copper levels are less sensitive and specific in identifying patients with ALF-WD than other available tests. More readily available laboratory tests including alkaline phosphatase, bilirubin and serum aminotransferases by contrast provides the most rapid and accurate method for diagnosis of ALF due to WD. (H EPATOLOGY 2008.) | en_US |
dc.format.extent | 158466 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Hepatology | en_US |
dc.title | Screening for Wilson disease in acute liver failure: A comparison of currently available diagnostic tests Potential conflict of interest: Nothing to report. | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Montefiore Medical Center, Bronx, NY | en_US |
dc.contributor.affiliationother | Yale University Medical Center, New Haven, CT | en_US |
dc.contributor.affiliationother | UT Southwestern Medical Center, Dallas, TX | en_US |
dc.contributor.affiliationother | UT Southwestern Medical Center, Dallas, TX | en_US |
dc.contributor.affiliationother | UT Southwestern Medical Center, Dallas, TX | en_US |
dc.contributor.affiliationother | University of Pittsburgh, Pittsburgh, PA | en_US |
dc.contributor.affiliationother | UT Southwestern Medical Center, Dallas, TX | en_US |
dc.contributor.affiliationother | Yale University Medical Center, New Haven, CT ; fax: 203-785-6645. ; Yale University Medical Center, 333 Cedar Street, LMP 1080, New Haven, CT 06520 | en_US |
dc.identifier.pmid | 18798336 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/61205/1/22446_ftp.pdf | |
dc.identifier.doi | http://dx.doi.org/10.1002/hep.22446 | en_US |
dc.identifier.source | Hepatology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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