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

doi:10.1016/0016-5085(91)90294-U

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 journal › Article › peer-review

160 Scopus citations

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 language	English (US)
Pages (from-to)	1129-1134
Number of pages	6
Journal	Gastroenterology
Volume	100
Issue number	4
DOIs	https://doi.org/10.1016/0016-5085(91)90294-U
State	Published - Apr 1991
Externally published	Yes

ASJC Scopus subject areas

Hepatology
Gastroenterology

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10.1016/0016-5085(91)90294-U

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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",

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doi = "10.1016/0016-5085(91)90294-U",

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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 - 1991/4

Y1 - 1991/4

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.

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

Abstract

ASJC Scopus subject areas

UN SDGs

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