Anillos de Kayser-Fleischer y la Enfermedad de Wilson, una revisión de literatura

Kayser-Fleischer Rings and Wilson's Disease, A Literature Review

Autores/as

DOI:

https://doi.org/10.59085/2789-7818.2022.51

Palabras clave:

Enfermedad de Wilson, Diagnóstico, Anillos de Kayser-Fleisher

Resumen

La enfermedad de Wilson, también llamada degeneración hepatolenticular, es una enfermedad autosómica recesiva que afecta tanto a hombres como a mujeres, actuando como una deficiencia en el metabolismo del cobre. Las personas con esta enfermedad pueden presentar manifestaciones neurológicas, hepáticas, oculares, entre otras. Una de las características presentes en las personas que tienen comprometido el sistema nervioso central son los anillos de Kayser-Fleischer que se manifiestan en los ojos que son anillos de cobre que se acumulan en la membrana de Descemet del globo ocular, formando anillos de color verde parduzco en su costado. La enfermedad de Wilson es el resultado de una alteración genética, lo que lleva a que el cobre no sea metabolizado y, en consecuencia, lo deje suelto en el torrente sanguíneo, acumulándose típicamente en el hígado y los ganglios basales. Esta revisión bibliográfica tiene como objetivo revisar puntos importantes de la enfermedad de Wilson y verificar si los anillos de Kayser-Fleischer son un punto intrínseco en el diagnóstico de esta, facilitando su detección precoz y, consecuentemente el tratamiento. A partir de este análisis se concluye que los anillos de Kayser-Fleischer no son específicos para la enfermedad de Wilson, sin embargo, son diferenciables frente a dicha enfermedad, porque son menos densas y tienen un color más tostado que marrón.

Palabras clave: Enfermedad de Wilson, anillos de Kayser Fleischer, Diagnóstico.

 

Abstract

Wilson's disease, also called hepatolenticular degeneration, is an autosomal recessive disease that affects both men and women, acting as a deficiency in copper metabolism. People with this disease may present neurological, hepatic, and ocular manifestations, among others. One of the characteristics present in people who have a compromised central nervous system are the Kayser-Fleischer rings, which are copper rings that accumulate in the Descemet’s membrane of the eye, forming brownish-green rings on its side. Wilson's disease is the result of a genetic alteration, which leads to copper not being metabolized and consequently leaving it loose in the bloodstream, typically accumulating in the liver and basal ganglia. This bibliographic review aims to review important points of Wilson's disease and verify if Kayser-Fleischer rings are an intrinsic point in the diagnosis of Wilson's disease and thus facilitate early diagnosis and consequently treatment. To carry out the bibliographic review, a systematic investigation was carried out, using the research sources mentioned below. To present novelties in the area of ​​Wilson's disease diagnosis, and consequently advance treatment and early diagnosis for a duly effective treatment, Kayser-Fleischer rings are not specific for Wilson's disease, however they are differentiable against this disease, because they are less dense and have a tanner color than brown.

Keywords: Wilson´s Disease, Kayser-Fleischer Rings, Diagnosis.

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Citas

(1) Członkowska A, Litwin T, Dusek P, Ferenci P, Lutsenko S, Medici V, Rybakowski JK, Weiss KH, Schilsky ML. Wilson disease. Nat Rev Dis Primers. 2018 Sep 6;4(1):21. doi: 10.1038/s41572-018-0018-3. PMID: 30190489; PMCID: PMC6416051.

(2) Pierson H, Yang H, Lutsenko S. Transporte de cobre e doenças: o que podemos aprender com os organoides?. Revisão anual de nutrição , 39 , 75-94, 2019. https://doi.org/10.1146/annurev-nutr-082018-124242

(3) Jayakanthan S, Braiterman LT, Hasan NM, Unger VM, Lutsenko S. Human copper transporter ATP7B (Wilson disease protein) forms stable dimers in vitro and in cells. J Biol Chem. 2017 Nov 17;292(46):18760-18774. doi: 10.1074/jbc.M117.807263. Epub 2017 Aug 24. PMID: 28842499; PMCID: PMC5704462.

(4) Socha P, Janczyk W, Dhawan A, Baumann U, D'Antiga L, Tanner S, Iorio R, Vajro P, Houwen R, Fischler B, Dezsofi A, Hadzic N, Hierro L, Jahnel J, McLin V, Nobili V, Smets F, Verkade HJ, Debray D. Wilson's Disease in Children: A Position Paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018 Feb;66(2):334-344. doi: 10.1097/MPG.0000000000001787. PMID: 29341979.

(5) Trumbo P, Yates AA, Schlicker S, Poos M. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc. 2001 Mar;101(3):294-301.

(6) Członkowska A, Litwin T, Dusek P, Ferenci P, Lutsenko S, Medici V, Rybakowski JK, Weiss KH, Schilsky ML. Wilson disease. Nat Rev Dis Primers. 2018 Sep 6;4(1):21. doi: 10.1038/s41572-018-0018-3. PMID: 30190489; PMCID: PMC6416051.

(7) Sandahl TD, Laursen TL, Munk DE, Vilstrup H, Weiss KH, Ott P. The Prevalence of Wilson's Disease: An Update. Hepatology. 2020 Feb;71(2):722-732. doi: 10.1002/hep.30911. Epub 2020 Jan 31. PMID: 31449670.

(8) Gromadzka G, Schmidt HH, Genschel J, Bochow B, Rodo M, Tarnacka B, Litwin T, Chabik G, Członkowska A. Frameshift and nonsense mutations in the gene for ATPase7B are associated with severe impairment of copper metabolism and with an early clinical manifestation of Wilson's disease. Clin Genet. 2005 Dec;68(6):524-32. doi: 10.1111/j.1399-0004.2005.00528.x. PMID: 16283883.

(9) Ferenci, P., Czlonkowska, A., Stremmel, W., Houwen, R., Rosenberg, W., Schilsky, M., Jansen, P., Moradpour, D., & Gitlin, J. (2012). EASL Clinical Practice Guidelines: Wilson’s disease. Journal of Hepatology, 56(3), 671–685.

https://doi.org/10.1016/j.jhep.2011.11.007

(10) Schroeder SM, Matsukuma KE, Medici V. Wilson disease and the differential diagnosis of its hepatic manifestations: a narrative review of clinical, laboratory, and liver histological features. Ann Transl Med. 2021 Sep;9(17):1394. doi: 10.21037/atm-21-2264. PMID: 34733946; PMCID: PMC8506558.

(11) Hedera P. Wilson's disease: A master of disguise. Parkinsonism Relat Disord. 2019 Feb;59:140-145. doi: 10.1016/j.parkreldis.2019.02.016. Epub 2019 Feb 14. PMID: 30797706.

(12) Wiggelinkhuizen M, Tilanus ME, Bollen CW, Houwen RH. Systematic review: clinical efficacy of chelator agents and zinc in the initial treatment of Wilson disease. Aliment Pharmacol Ther. 2009 May 1;29(9):947-58. doi: 10.1111/j.1365-2036.2009.03959.x. PMID: 19210288.

(13) Liu J, Luan J, Zhou X, Cui Y, Han J. Epidemiology, diagnosis, and treatment of Wilson's disease. Intractable Rare Dis Res. 2017 Nov;6(4):249-255. doi: 10.5582/irdr.2017.01057. PMID: 29259852; PMCID: PMC5735277.

(14) Cleymaet S, Nagayoshi K, Gettings E, Faden J. A review and update on the diagnosis and treatment of neuropsychiatric Wilson disease. Expert Rev Neurother. 2019 Nov;19(11):1117-1126. doi: 10.1080/14737175.2019.1645009. Epub 2019 Jul 25. PMID: 31314605.

(15) Sarapura-Castro E, RamÍrez-QuiÑones J, Cornejo-Olivas M. Panda with "bright eyes": a rare sign in Wilson disease. Arq Neuropsiquiatr. 2020 Jun 29;78(8):525. doi: 10.1590/0004-282X20200036. PMID: 32627810.)

(16) Youn J, Kim JS, Kim HT, Lee JY, Lee PH, Ki CS, Cho JW. Characteristics of neurological Wilson's disease without Kayser-Fleischer ring. J Neurol Sci. 2012 Dec 15;323(1-2):183-6. doi: 10.1016/j.jns.2012.09.013. Epub 2012 Oct 5. PMID: 23043908.

(17) Dzieżyc-Jaworska, K., Litwin, T., & Członkowska, A. (2019). Clinical manifestations of Wilson disease in organs other than the liver and brain. Annals of Translational Medicine, 7(S2), S62–S62. https://doi.org/10.21037/atm.2019.03.30

(18) Pandey N, John S. Kayser-Fleischer Ring. 2022 Jan 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29083643.

(19) Esmaeli B, Burnstine MA, Martonyi CL, Sugar A, Johnson V, Brewer GJ. Regressão dos anéis de Kayser-Fleischer durante a terapia oral com zinco: correlação com manifestações sistêmicas da doença de Wilson. Córnea 1996; 15(6): 582-588.

(20) Rathi A, Takkar B, Gaur N, Maharana PK. Optical coherence tomography of the Kayser-Fleischer ring: an ancillary diagnostic tool for Wilson's disease in children. BMJ Case Rep. 2017 May 5;2017:bcr2017220007. doi: 10.1136/bcr-2017-220007. PMID: 28476917; PMCID: PMC5614143.

(21) Youn J, Kim JS, Kim HT, Lee JY, Lee PH, Ki CS, Cho JW. Characteristics of neurological Wilson's disease without Kayser-Fleischer ring. J Neurol Sci. 2012 Dec 15;323(1-2):183-6. doi: 10.1016/j.jns.2012.09.013. Epub 2012 Oct 5. PMID: 23043908.

(22) Choudhury N, Quraishi SB, Atiqullah A, Khan MSI, Al Mahtab M, Akbar SM. High Prevalence of Wilson's Diseases with Low Prevalence of Kayser-Fleischer Rings among Patients with Cryptogenic Chronic Liver Diseases in Bangladesh. Euroasian J Hepatogastroenterol. 2019 Jul-Dec;9(2):67-70. doi: 10.5005/jp-journals-10018-1299. PMID: 32117693; PMCID: PMC7047311.

(23) Fleming CR, Dickson ER, Wahner HW, Hollenhorst RW, McCall JT. Anéis corneanos pigmentados na doença hepática não-Wilsoniana. Anais de medicina interna 1977; 86(3): 285-288.

(24) Stremmel, W., Meyerrose, K.-W., Niederau, C., Hefter, H., Kreuzpaintner, G., & Strohmeyer, G. Wilson Disease: Clinical Presentation, Treatment, and Survival, 1991. http://annals.org/pdfaccess.ashx?url=/data/journals/aim/19737/

(25) Kleine RT, Mendes R, Pugliese R, Miura I, Danesi V, Porta G. Wilson’s disease: An analysis of 28 Brazilian children. Clinics, 67(3), 231–235, 2012. https://doi.org/10.6061/clinics/2012(03)05.

(26) Andrade Sócio S, Ferreira AR, Druve E, Fagundes T, Leitão M, Roquete V, Rocha Pimenta J, De Campos L, Campos F, Penna FJ (n.d.). Wilson’s disease in children and adolescents: diagnosis and treatment Doença de Wilson em crianças e adolescentes: diagnóstico e tratamento.

(27) Bem RS, Muzzillo DA, Deguti MM, Barbosa ER, Werneck LC, Teive HAG. Wilson’s disease in southern Brazil: A 40-year follow-up study. Clinics, 66(3), 411–416, 2011. https://doi.org/10.1590/S1807-59322011000300008.

(28) Paola Y, Herrera E, Manuel Muñoz Ruiz L, Carlos J, Gutiérrez R. Enfermedad de Wilson: revisión del tema. N.d.

(29) Nagral A, Sarma MS, Matthai J, Kukkle PL, Devarbhavi H, Sinha S, Alam S, Bavdekar A, Dhiman RK, Eapen CE, Goyal V, Mohan N, Kandadai RM, Sathiyasekaran M, Poddar U, Sibal A, Sankaranarayanan S, Srivastava A, Thapa BR, Wadia PM, Yachha SK, Dhawan A. Wilson's Disease: Clinical Practice Guidelines of the Indian National Association for Study of the Liver, the Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition, and the Movement Disorders Society of India. J Clin Exp Hepatol. 2019 Jan-Feb;9(1):74-98. doi: 10.1016/j.jceh.2018.08.009. Epub 2018 Sep 3. Erratum in: J Clin Exp Hepatol. 2020 Jan-Feb;10(1):99. PMID: 30765941; PMCID: PMC6363961.

(30) Langwińska-Wośko E, Litwin T, Dzieżyc K, Członkowska A. The sunflower cataract in Wilson's disease: pathognomonic sign or rare finding? Acta Neurol Belg. 2016 Sep;116(3):325-8. doi: 10.1007/s13760-015-0566-1. Epub 2015 Nov 17. PMID: 26577266; PMCID: PMC4989003.

(31) Nguyen Thi Mai Huong, Nguyen Pham Anh Hoa, Ngo Diem Ngoc, Nguyen Thi Phuong Mai, Pham Hai Yen, Hoàng Thị Vân Anh, Giang Hoa, Tran Minh Dien. (2022) Mutation spectrum of ATP7B gene in pediatric patients with Wilson disease in Vietnam. Molecular Genetics and Metabolism Reports 31, 100861.

(32) Feoktistova Victorava Liudmila, Clark Feoktistova Yulia. El metabolismo del cobre. Sus consecuencias para la salud humana. Medisur [Internet]. 2018 ; 16( 4 ): 579-587. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2018000400013&lng=es.

Publicado

15-03-2023

Cómo citar

Nogueira Junior, R. I., & Meireles Duarte, G. . F. (2023). Anillos de Kayser-Fleischer y la Enfermedad de Wilson, una revisión de literatura: Kayser-Fleischer Rings and Wilson’s Disease, A Literature Review. Epicentro - Revista De Investigación Ciencias De La Salud, 2(4), 58–67. https://doi.org/10.59085/2789-7818.2022.51