title: Value of histochemical stains for copper in the diagnosis of Wilson's disease.
abstract: OBJECTIVE
  The histochemical demonstration of hepatic copper is important in the diagnosis of Wilson's disease (WD). Conflicting results have been published with regard to the ability of different histochemical methods to demonstrate copper storage in the liver. Therefore, we evaluated the diagnostic value of three available histochemical methods in a large series of patients affected by WD.
  
  
  RESULTS
  Seventy-nine consecutive liver needle biopsies, from 74 patients, 39 males and 35 females, aged 4-60 years (mean age 28.5 years) were stained with orcein, rhodanine and using Timm's method. On the basis of the histological picture, liver biopsies were subdivided into three groups: group A, steatosis; group B, interface hepatitis; group C, chronic hepatitis with bridging fibrosis and/or cirrhosis. In group A, 30.4% of the cases were positive using Timm's method, vs 13.2% using the rhodanine and 17.5% using the orcein method. In group B, Timm's method was positive in 40.1% while rhodanine and orcein showed positivity in 26.7%. In group C, the Timm's method stained 58.6%, rhodanine 36.6% and orcein 29.3% positively.
  
  
  CONCLUSIONS
  Our data show that: (1) Timm's silver stain is the most sensitive method for the demonstration of copper in all cases of WD; (2) rhodanine and orcein have minor value in the diagnosis of WD, especially in the early stages of the disease; (3) to increase the diagnostic value of histochemistry for copper multiple histochemical stains in serial sections are required; and (4) although hepatic copper concentration is highest in the early stages of WD, the histochemical demonstration fails in a large number of cases.
authors.affiliation: Dipartimento di Citomorfologia, University of Cagliari, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pilloni
authors.forename: S
authors.initials: S
authors.lastname: Lecca
authors.forename: P
authors.initials: P
authors.lastname: Van Eyken
authors.forename: C
authors.initials: C
authors.lastname: Flore
authors.forename: L
authors.initials: L
authors.lastname: Demelia
authors.forename: G
authors.initials: G
authors.lastname: Pilleri
authors.forename: A M
authors.initials: AM
authors.lastname: Nurchi
authors.forename: A M
authors.initials: AM
authors.lastname: Farci
authors.forename: R
authors.initials: R
authors.lastname: Ambu
authors.forename: F
authors.initials: F
authors.lastname: Callea
authors.forename: G
authors.initials: G
authors.lastname: Faa
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004396:Coloring Agents; D003300:Copper / Q000032:analysis*; D005260:Female; D006527:Hepatolenticular Degeneration / Q000175:diagnosis*; D006801:Humans; D008099:Liver / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D004396:Coloring Agents; D003300:Copper