title: Chronic copper toxicosis presenting as liver failure in an Australian child.
abstract: A 20 month old Caucasian male child, after a five week illness, developed liver failure which was successfully treated by liver transplantation. The explanted liver had a histology identical to that seen in Indian childhood cirrhosis and its copper content was increased tenfold. Water used to prepare the child's milk feeds came from a bore via copper conduits and at times contained 120 mumol/l of copper, eight times the recommended maximum for human consumption. Because non-Indian cases of Indian childhood cirrhosis associated with excess copper ingestion are increasingly being recognised, and as early treatment can restore normal liver morphology, we support the use of the previously suggested alternative term for this condition, ie; 'copper-associated liver disease in childhood'. Measurement of hepatic copper concentrations in all children less than six years of age who develop hepatic failure of unknown cause will increase its recognition. On diagnosis sources of increased dietary copper should be investigated to ensure that younger siblings are not similarly exposed.
authors.affiliation: Department of Pathology, Royal Brisbane Hospital, Qld.
authors.forename: L A
authors.initials: LA
authors.lastname: Price
authors.forename: N I
authors.initials: NI
authors.lastname: Walker
authors.forename: A E
authors.initials: AE
authors.lastname: Clague
authors.forename: I D
authors.initials: ID
authors.lastname: Pullen
authors.forename: S J
authors.initials: SJ
authors.lastname: Smits
authors.forename: T H
authors.initials: TH
authors.lastname: Ong
authors.forename: M
authors.initials: M
authors.lastname: Patrick
mesh_terms: D001315:Australia; D056486:Chemical and Drug Induced Liver Injury; D003300:Copper / Q000506:poisoning*; D004032:Diet / Q000009:adverse effects; D006801:Humans; D007223:Infant; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000150:complications / Q000473:pathology; D008107:Liver Diseases / Q000150:complications / Q000473:pathology; D017093:Liver Failure / Q000175:diagnosis / Q000209:etiology*; D008297:Male
chemical_list: D003300:Copper