Document Detail


Treatment of Wilson's disease with zinc. XVII: treatment during pregnancy.
MedLine Citation:
PMID:  10655259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Therapy of Wilson's disease continues to evolve. In 1997, zinc acetate was added to the list of drugs approved by the Food and Drug Administration, which includes penicillamine and trientine. The mechanism of zinc's anticopper action is unique. It induces intestinal cell metallothionein, which binds copper and prevents its transfer into blood. As intestinal cells die and slough, the contained copper is eliminated in the stool. Thus, zinc prevents the intestinal absorption of copper. It is universally agreed that pregnant Wilson's disease patients should remain on anticopper therapy during pregnancy. There are numerous reports of such patients stopping penicillamine therapy to protect their fetus from teratogenicity, only to undergo serious deterioration and even death from renewed copper toxicity. Penicillamine and trientine have teratogenic effects in animals, and penicillamine has known teratogenic effects in humans. In this report we discuss the results of 26 pregnancies in 19 women who were on zinc therapy throughout their pregnancy. The evidence is good that zinc protects the health of the mother during pregnancy. Fetal outcomes were generally quite good, although one baby had a surgically correctable heart defect and one had microcephaly.
Authors:
G J Brewer; V D Johnson; R D Dick; P Hedera; J K Fink; K J Kluin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  31     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-02-24     Completed Date:  2000-02-24     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  364-70     Citation Subset:  IM    
Affiliation:
Department of Human Genetics, Division of Speech Pathology, Michigan Medical School, Ann Arbor, MI, USA. brewergj@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Copper / urine
Female
Hepatolenticular Degeneration / drug therapy*,  physiopathology,  urine
Humans
Maternal Welfare
Pregnancy
Pregnancy Complications / drug therapy*,  physiopathology,  urine
Pregnancy Outcome
Treatment Outcome
Zinc / therapeutic use*
Grant Support
ID/Acronym/Agency:
1RO1NS33645-01/NS/NINDS NIH HHS; 1RO1NS36177-01A10/NS/NINDS NIH HHS; MO1-RR00042/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
7440-50-8/Copper; 7440-66-6/Zinc
Comments/Corrections
Comment In:
Hepatology. 2000 Feb;31(2):531-2   [PMID:  10655282 ]
Hepatology. 2000 Oct;32(4 Pt 1):877   [PMID:  11041690 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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