EASL Clinical Practice Guidelines

Differential diagnosis

Acute hepatitis with Wilson's disease presents similarly to any other acute cases of hepatitis. Similarly, Wilson's disease should enter into the diagnosis of all patients with chronic hepatitis and cirrhosis, as routine histologic changes are nonspecific. Wilson's disease should be considered when acute hepatitis is accompanied by rapid onset of jaundice and hemolytic anemia. During adolescence, Wilson's disease presenting with neurologic symptoms may be misdiagnosed as a behavioural problem because initial symptoms may be subtle. More advanced movement disorders in a young person should provoke consideration of Wilson's disease, but the diagnosis may be overlooked where the presentation suggests a primarily psychological or psychiatric disorder.