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Old 05-30-2011
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Liver what is the gold standard for wilson disease diagnosis?

Is it the dry weight of copper from a liver biopsy?

or

Is it increased excretion of urinary copper after penicillamine administration?

Fischer says the latter, UW advocates the former

Last edited by docoftheworld; 05-30-2011 at 08:51 PM.
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Old 05-30-2011
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but levels of ceruloplasmin and copper in the blood, as well of the amount of copper excreted in the urine during a 24 hour period, are together used to form an impression of the amount of copper in the body. The combination of neurological symptoms, Kayser-Fleisher rings and a low ceruloplasmin level is considered sufficient for the diagnosis of Wilson disease. In many cases, however, further tests are needed. The “gold standard” or most ideal test is a liver biopsy.

http://www.acg.gi.org/patients/gihea...sondisease.asp
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I agree that its the gold, but why on earth does Fischer say its the increased urinary CU after penicillamine ... oh well, they wont bring BOTH in the same question on the test
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Quote:
Originally Posted by docoftheworld View Post
I agree that its the gold, but why on earth does Fischer say its the increased urinary CU after penicillamine ... oh well, they wont bring BOTH in the same question on the test
Probably just because it's inconvenient, invasive, painful and not without risks to do a liver biopsy?


In general I notice that a lot of "gold standards" give unequivocal diagnoses, but often given the inconveniences and risk factors involved, they are not preferred clinically.
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i very much doubt they would include both choices on a USMLE question (as you've kindly elucidated)
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