Table 6.
Interpretation of Tests Used in Monitoring Drug Treatment of Wilson's Disease.
| Zinc | D-penicillamine/trientine | |
|---|---|---|
| Initial treatment | U Cu 100–500 μg/d S free Cu > 25 μg/dL U Zn > 2000 μg/d |
U Cu > 500 μg/d S free Cu > 25 μg/dL |
| Good control (Maintenance) | U Cu < 75 μg/d S free Cu 10–15 μg/dL |
U Cu 200–500 μg/d S free Cu 10–15 μg/dL |
| Non-compliance/Inadequate dose | U Zn < 2000 μg/d S free Cu > 15 μg/dL |
U Cu < 200 μg/d U Cu > 500 μg/d S free Cu > 15 μg/dL |
| Overtreatment | U Cu < 25 μg/d S. free Cu < 5 μg/dL |
U Cu < 200 μg/d S. free Cu < 5 μg/dL |
To document therapeutic efficiency, urinary copper excretion after 2 days of D-penicillamine cessation should be <50 μg in 24 h; If higher, it suggests poor compliance.138
U Cu, 24 h urinary copper, U Zn, 24 h urinary zinc, S. free Cu, Serum free copper, DP, D-penicillamine.