•Outcome in wilson disease
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•Despite adequate chelation therapy the outcome is unpredictable with 48% mortality in hospital series. Common outcome seen are:
–Rapid and complete improvement of hepatic lesions including early cirrhosis
–Initial deterioration of neurological symptoms but with eventual improvement with few residual handicaps (speech and handwriting)
–Relentless progression and death as in fulminant hepatic failure
–Relentless progression and death in advanced cirrhosis
–Normal healthy outcome in asymptomatic siblings of index patient who take regular chelation therapy