[The reassessment of the diagnostic value of 24-hour urinary copper excretion in children with Wilson's disease].
OBJECTIVE
To reassess the diagnostic value of 24 hour urinary copper excretion in children with Wilson disease (WD).


METHODS
From July 2005 to June 2007, inpatients over three years old in a pediatric liver center were assigned into WD and non-WD group.


RESULTS
94 patients, including 26 cases in WD and 68 in non-WD group, were enrolled in this study. The median of 24 h urinary copper excretion was 98.5 microg in WD group and 25.8 microg in the non-WD group (Z = -6.111, P equal to 0.000). The area under receiver operator curve (ROC) was 0.909 (95% CI: 0.839-0.979, P equal to 0.000). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84.6%, 91.2%, 89.4%, 78.6% and 93.9% respectively using 52.0 ug as a cutoff value, and 50.0%, 97.1%, 84.0%, 86.7% and 83.5% using 100 microg as a cutoff value. The goodness of fitness of 52 microg criteria was significantly higher than 100 microg criteria (kappacoefficient 0.760, 0.541 respectively, P equal to 0.000).


CONCLUSIONS
Comparing to 100, 52 microg of 24 h urinary copper excretion as a cutoff value significantly improves the sensitivity and accuracy for diagnosing WD in children.
Childrens Hospital of Fudan University, Shanghai 201102, China.
Yi
Y
Lu
Xiao-Qing
XQ
Liu
Xiao-Hong
XH
Wang
Jian-She
JS
Wang
D000293:Adolescent; D000367:Age Factors; D002570:Ceruloplasmin; D002648:Child; D002675:Child, Preschool; D003300:Copper / Q000652:urine*; D005260:Female; D006505:Hepatitis / Q000175:diagnosis* / Q000473:pathology / Q000652:urine; D006506:Hepatitis A / Q000175:diagnosis / Q000473:pathology / Q000652:urine; D006527:Hepatolenticular Degeneration / Q000175:diagnosis* / Q000473:pathology / Q000652:urine; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D010396:Penicillamine; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013997:Time Factors
D003300:Copper; D002570:Ceruloplasmin; D010396:Penicillamine