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Clinical course of WD. After a subclinical period, WD presents with hepatic (mean age, 17.6 years) and/or neurological (mean age, 23.4 years) symptoms. Approximately 60% have both. Three percent to 5% present with acute hepatic failure (ALF), which is fatal without liver transplantation. In the remaining patients, the medical treatment aims at preventing or stopping disease progression and, if possible, inducing a regression of symptoms.
