How should I manage a patient diagnosed with Wilson's Disease who presents with hepatic symptoms?

Management of a patient with Wilson's disease presenting with hepatic symptoms involves prompt initiation of chelation therapy to reduce copper accumulation, which is the underlying cause of liver damage. First-line treatment typically includes agents such as penicillamine or trientine, which bind copper and promote its excretion, thereby improving hepatic function and preventing progression to cirrhosis or liver failure ¹ (Seo, 2006). Regular monitoring of liver function tests and copper levels is essential to assess treatment efficacy and adjust therapy accordingly ¹. In cases of acute liver failure or decompensated cirrhosis, referral for liver transplantation should be considered as a definitive treatment option ¹ (Seo, 2006). Supportive care addressing complications such as coagulopathy, encephalopathy, and portal hypertension should be provided in line with standard hepatic management protocols ¹. Nutritional advice to avoid copper-rich foods complements pharmacological treatment ¹. Recent literature emphasizes the importance of early diagnosis and individualized treatment plans to improve long-term outcomes, highlighting that newer chelators and zinc therapy may be beneficial in certain patient subsets, although penicillamine remains the mainstay [Seo, 2006]. Overall, management requires a multidisciplinary approach involving hepatologists, neurologists, and dietitians to optimize care ¹ (Seo, 2006).