MODERN ASPECTS OF PATHOGENETIC TREATMENT WITH ZINC SALTS OF PATIENTS WITH WILSON'S DISEASE IN UKRAINE

Ivan Voloshyn-Gaponov

Abstract


The aim – to study the effectiveness of zinc salts in the treatment of patients with neurological forms of Wilson's disease (WD).

Materials and methods. The analysis of the treatment results of 128 patients with hepatocerebral degeneration (71 men and 57 women) in the State Institution “Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine” was carried out. At the time of hospitalization, the age of patients ranged from 5 to 55 years, an average of 27.3 years, and at the time of debut of the disease - from 1 year to 40 years, an average of 21.3 years. 33 patients underwent monotherapy with zinc salts, 63 – combined therapy with small doses of penicillamine and zinc salts, 32 – monotherapy with penicillamine.

Results. Because of the treatment, 67.1 % of patients showed an improvement in neuropsychiatric status: speech improved significantly, tremor of the extremities and the amplitude of hyperkinesis decreased, muscle tone decreased, and cognitive functions improved. According to the international two-level rating scale (UWDRS), the total pathology index decreased by 21 points. Zinc salts are effective and low-toxic and can be the drug of choice in the treatment of patients with hepatocerebral degeneration in the pre-symptomatic stage of the disease, as well as at the stage of maintenance treatment, both as monotherapy and in combination with penicillamine. However, zinc salts and penicillamine are not enough for the treatment and rehabilitation of patients with hepatocerebral degeneration. Therefore, taking into account the clinical picture and the data of additional research methods, it is necessary to conduct courses of symptomatic treatment at least 1-2 times a year.

Conclusions. Thus, it can be noted that zinc salts are very effective and low toxic, and, therefore, can be the drug of choice in the treatment of patients with HCD in the pre-symptomatic stage of the disease, as well as at the stage of maintenance therapy as a single drug, and in combination with penicillamine or other chelate drugs.


Keywords


hepatocerebral degeneration; Wilson’s disease; clinical and neurological symptoms; treatment; zinc salts; penicillamine; trientine; tetrathiomolybdate

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References


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DOI: http://dx.doi.org/10.21303/2585-663.2019.001094

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