Resolution of cranial MRI and SPECT abnormalities in a patient with Wilson's disease following oral zinc monotherapy.
A 38-year-old woman with Wilson's disease developed neurological deterioration after 25 years of low-dose penicillamine administration. She showed an akinetic-rigid syndrome and cerebellar motor ataxia. Brain MRI showed increased signal intensity at the bilateral pons, midbrain, putamen, and thalamus. 123I-IMP-SPECT revealed a diffuse reduction of cerebral blood flow at the bilateral cerebral hemisphere including the basal ganglia. After the patient's regimen was changed to zinc therapy, her neurological condition gradually improved, and she showed almost complete recovery within two years. Serial MRI and SPECT studies showed a marked improvement in the lesions.
The First Department of Internal Medicine, Osaka Medical College, Japan. in1212@poh.osaka-med.ac.jp
Shimon
S
Ishida
Yoshimitsu
Y
Doi
Kazushi
K
Yamane
Masakazu
M
Sugino
Fumiharu
F
Kimura
Toshiaki
T
Hanafusa
Hideo
H
Fukui
Hiroshi
H
Tamai
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002524:Cerebellar Ataxia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D002560:Cerebrovascular Circulation; D005260:Female; D006527:Hepatolenticular Degeneration / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D020367:Iofetamine; D008279:Magnetic Resonance Imaging; D010396:Penicillamine / Q000009:adverse effects; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D019345:Zinc Acetate / Q000627:therapeutic use*
D019275:Radiopharmaceuticals; D020367:Iofetamine; D019345:Zinc Acetate; D010396:Penicillamine