•Hepatic
presentation:
–Most
patients including asymptomatic demonstrate some degree of hepatic damage.
Anorexia, vague abdominal pain, lethargy and epistaxis are non specific
symptoms.
–Most
common presentation is that of chronic liver disease with signs of liver cell
failure and portal hypertension
–Some
patients present as acute hepatitis causing initial diagnostic confusion with
infective hepatitis
–Hepatic
insufficiency may develop rapidly and result in signs of fulminant hepatic
failure
–
•Gallstones
have been associated with WD in children