Zinc mono-therapy in pre-symptomatic Chinese children with Wilson disease: a single center, retrospective study.
BACKGROUND
There is no official consensus regarding zinc therapy in pre-symptomatic children with Wilson Disease (WD); more data is needed.


OBJECTIVE
To investigate the safety and efficacy of zinc gluconate therapy for Chinese children with pre-symptomatic WD.


METHODS
We retrospectively analyzed pre-symptomatic children receiving zinc gluconate in a single Chinese center specialized in pediatric hepatology. Short-term follow-up data on safety and efficacy were presented, and effects of different zinc dosages were compared.


RESULTS
30 children (21 males) aged 2.7 to 16.8 years were followed for up to 4.4 years; 26 (87%) children had abnormal ALT at baseline. Most patients (73%) received higher than the currently recommended dose of elemental zinc. Zinc gluconate significantly reduced mean ALT (p<0.0001), AST (p<0.0001), GGT (p<0.0001) levels after 1 month, and urinary copper excretion after 6 months (p<0.0054). Mean direct bilirubin levels dropped significantly at 1 month (p = 0.0175), 3 months (p = 0.0010), and 6 months (p = 0.0036). Serum zinc levels gradually increased and reached a significantly higher level after 6 months (p<0.0026), reflecting good compliance with the therapy. Complete blood count parameters did not change throughout the analysis period. 8 children experienced mild and transient gastrointestinal side effects. The higher zinc dose did not affect treatment response and was not associated with different or increased side effects when compared to conventional zinc dose.


CONCLUSIONS
In our cohort, zinc gluconate therapy for Chinese children with pre-symptomatic WD was effective, and higher initial dose of elemental zinc had the same level of efficacy as the conventional dose.
Liver Center, Children's Hospital of Fudan University, Shanghai, China.
Kuerbanjiang
K
Abuduxikuer
Department of Pediatrics, Jinshan Hospital of Fudan University, Shanghai, China.
Jian-She
JS
Wang
D000293:Adolescent; D058070:Asymptomatic Diseases; D002614:Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China; D003300:Copper / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006527:Hepatolenticular Degeneration / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D015032:Zinc / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
D002614:Chelating Agents; D003300:Copper; D015032:Zinc