Mania in a Patient with Wilson's Disease Awaiting Liver Transplant

摘要

To the Editor. Wilson's disease is associated with neuropsychiatric disorders such as psychosis, depression, and movement disorders.1 Mania is an uncommon neuropsychiatric manifestation in Wilson's disease. We report a young woman with Wilson's disease who developed manic symptoms while awaiting a liver transplant.Case ReportMiss AC, a 19-year-old woman, had been diagnosed with Wilson's disease 2 years before the onset of her neuropsychiatric manifestations. She had developed ascites and other features suggestive of chronic liver disease. Her liver function tests, serum ceruloplasmin levels, urine copper levels, and serum copper levels were suggestive of Wilson's disease. An ultrasound of the abdomen revealed a cirrhotic liver with portal hypertension. A brainMRI did not reveal any abnormality. A slit lamp examination done by the ophthalmologist revealed bilateral Kayser-Flescher rings, and she was started on D-penicillamine, 750 mg/day. Since there was a progressive deterioration in her liver function, a liver transplant was advised by the gastroenterologist. Due to the pending investigations of the patient, the liver transplant was planned at a later date and her mother gave consent for partial liver donation. During this period, she developed insomnia, increased talkativeness and increased activity.