Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure

David H. Berman, Robert I. Leventhal, Judith S. Gavaler, Evan M. Cadoff, David H. Van Thiel

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

Establishing a diagnosis of fulminant Wilson's disease can be difficult because Kayser-Fleischer rings may not be present and parameters of copper metabolism, including serum and urinary copper, and serum ceruloplasmin levels are neither specific nor diagnostic. In this study, ratios of both the serum alkaline phosphatase to total bilirubin and aspartate transaminase to alanine transaminase were constructed to evaluate their usefulness in differentiating fulminant hepatic failure caused by Wilson's disease (n = 6) from other etiologies (n = 43). An analysis of the data showed that cutoff values of < 2.0 for the alkaline phosphatase-total bilirubin ratio and > 4.0 for the aspartate transaminase ratio were associated with a diagnosis of fulminant hepatic failure caused by Wilson's disease only (P < 0.001). The alkaline phosphatase-total bilirubin ratio of < 2.0 provided 100% sensitivity and specificity in identifying fulminant hepatic failure caused by Wilson's disease from other types of fulminant hepatic failure.

Original languageEnglish (US)
Pages (from-to)1129-1134
Number of pages6
JournalGastroenterology
Volume100
Issue number4
StatePublished - 1991
Externally publishedYes

Fingerprint

Hepatolenticular Degeneration
Acute Liver Failure
Liver Failure
Hepatitis
Aspartate Aminotransferases
Bilirubin
Alkaline Phosphatase
Copper
Serum
Ceruloplasmin
Alanine Transaminase
Sensitivity and Specificity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Berman, D. H., Leventhal, R. I., Gavaler, J. S., Cadoff, E. M., & Van Thiel, D. H. (1991). Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure. Gastroenterology, 100(4), 1129-1134.

Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure. / Berman, David H.; Leventhal, Robert I.; Gavaler, Judith S.; Cadoff, Evan M.; Van Thiel, David H.

In: Gastroenterology, Vol. 100, No. 4, 1991, p. 1129-1134.

Research output: Contribution to journalArticle

Berman, DH, Leventhal, RI, Gavaler, JS, Cadoff, EM & Van Thiel, DH 1991, 'Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure', Gastroenterology, vol. 100, no. 4, pp. 1129-1134.
Berman, David H. ; Leventhal, Robert I. ; Gavaler, Judith S. ; Cadoff, Evan M. ; Van Thiel, David H. / Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure. In: Gastroenterology. 1991 ; Vol. 100, No. 4. pp. 1129-1134.
@article{659be26b311c444eaa261180068cb50f,
title = "Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure",
abstract = "Establishing a diagnosis of fulminant Wilson's disease can be difficult because Kayser-Fleischer rings may not be present and parameters of copper metabolism, including serum and urinary copper, and serum ceruloplasmin levels are neither specific nor diagnostic. In this study, ratios of both the serum alkaline phosphatase to total bilirubin and aspartate transaminase to alanine transaminase were constructed to evaluate their usefulness in differentiating fulminant hepatic failure caused by Wilson's disease (n = 6) from other etiologies (n = 43). An analysis of the data showed that cutoff values of < 2.0 for the alkaline phosphatase-total bilirubin ratio and > 4.0 for the aspartate transaminase ratio were associated with a diagnosis of fulminant hepatic failure caused by Wilson's disease only (P < 0.001). The alkaline phosphatase-total bilirubin ratio of < 2.0 provided 100{\%} sensitivity and specificity in identifying fulminant hepatic failure caused by Wilson's disease from other types of fulminant hepatic failure.",
author = "Berman, {David H.} and Leventhal, {Robert I.} and Gavaler, {Judith S.} and Cadoff, {Evan M.} and {Van Thiel}, {David H.}",
year = "1991",
language = "English (US)",
volume = "100",
pages = "1129--1134",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Clinical differentiation of fulminant Wilsonian hepatitis from other causes of hepatic failure

AU - Berman, David H.

AU - Leventhal, Robert I.

AU - Gavaler, Judith S.

AU - Cadoff, Evan M.

AU - Van Thiel, David H.

PY - 1991

Y1 - 1991

N2 - Establishing a diagnosis of fulminant Wilson's disease can be difficult because Kayser-Fleischer rings may not be present and parameters of copper metabolism, including serum and urinary copper, and serum ceruloplasmin levels are neither specific nor diagnostic. In this study, ratios of both the serum alkaline phosphatase to total bilirubin and aspartate transaminase to alanine transaminase were constructed to evaluate their usefulness in differentiating fulminant hepatic failure caused by Wilson's disease (n = 6) from other etiologies (n = 43). An analysis of the data showed that cutoff values of < 2.0 for the alkaline phosphatase-total bilirubin ratio and > 4.0 for the aspartate transaminase ratio were associated with a diagnosis of fulminant hepatic failure caused by Wilson's disease only (P < 0.001). The alkaline phosphatase-total bilirubin ratio of < 2.0 provided 100% sensitivity and specificity in identifying fulminant hepatic failure caused by Wilson's disease from other types of fulminant hepatic failure.

AB - Establishing a diagnosis of fulminant Wilson's disease can be difficult because Kayser-Fleischer rings may not be present and parameters of copper metabolism, including serum and urinary copper, and serum ceruloplasmin levels are neither specific nor diagnostic. In this study, ratios of both the serum alkaline phosphatase to total bilirubin and aspartate transaminase to alanine transaminase were constructed to evaluate their usefulness in differentiating fulminant hepatic failure caused by Wilson's disease (n = 6) from other etiologies (n = 43). An analysis of the data showed that cutoff values of < 2.0 for the alkaline phosphatase-total bilirubin ratio and > 4.0 for the aspartate transaminase ratio were associated with a diagnosis of fulminant hepatic failure caused by Wilson's disease only (P < 0.001). The alkaline phosphatase-total bilirubin ratio of < 2.0 provided 100% sensitivity and specificity in identifying fulminant hepatic failure caused by Wilson's disease from other types of fulminant hepatic failure.

UR - http://www.scopus.com/inward/record.url?scp=0025793204&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025793204&partnerID=8YFLogxK

M3 - Article

VL - 100

SP - 1129

EP - 1134

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 4

ER -