Skip Navigation
Genetics Home Reference: your guide to understanding genetic conditions
http://ghr.nlm.nih.gov/     A service of the U.S. National Library of Medicine®

Wilson disease

Reviewed January 2014

What is Wilson disease?

Wilson disease is an inherited disorder in which excessive amounts of copper accumulate in the body, particularly in the liver, brain, and eyes. The signs and symptoms of Wilson disease usually first appear between the ages of 6 and 45, but they most often begin during the teenage years. The features of this condition include a combination of liver disease and neurological and psychiatric problems.

Liver disease is typically the initial feature of Wilson disease in affected children and young adults; individuals diagnosed at an older age usually do not have symptoms of liver problems, although they may have very mild liver disease. The signs and symptoms of liver disease include yellowing of the skin or whites of the eyes (jaundice), fatigue, loss of appetite, and abdominal swelling.

Nervous system or psychiatric problems are often the initial features in individuals diagnosed in adulthood and commonly occur in young adults with Wilson disease. Signs and symptoms of these problems can include clumsiness, tremors, difficulty walking, speech problems, impaired thinking ability, depression, anxiety, and mood swings.

In many individuals with Wilson disease, copper deposits in the front surface of the eye (the cornea) form a green-to-brownish ring, called the Kayser-Fleischer ring, that surrounds the colored part of the eye. Abnormalities in eye movements, such as a restricted ability to gaze upwards, may also occur.

How common is Wilson disease?

Wilson disease is a rare disorder that affects approximately 1 in 30,000 individuals.

What genes are related to Wilson disease?

Wilson disease is caused by mutations in the ATP7B gene. This gene provides instructions for making a protein called copper-transporting ATPase 2, which plays a role in the transport of copper from the liver to other parts of the body. Copper is necessary for many cellular functions, but it is toxic when present in excessive amounts. The copper-transporting ATPase 2 protein is particularly important for the elimination of excess copper from the body. Mutations in the ATP7B gene prevent the transport protein from functioning properly. With a shortage of functional protein, excess copper is not removed from the body. As a result, copper accumulates to toxic levels that can damage tissues and organs, particularly the liver and brain.

Research indicates that a normal variation in the PRNP gene may modify the course of Wilson disease. The PRNP gene provides instructions for making prion protein, which is active in the brain and other tissues and appears to be involved in transporting copper. Studies have focused on the effects of a PRNP gene variation that affects position 129 of the prion protein. At this position, people can have either the protein building block (amino acid) methionine or the amino acid valine. Among people who have mutations in the ATP7B gene, it appears that having methionine instead of valine at position 129 of the prion protein is associated with delayed onset of symptoms and an increased occurrence of neurological symptoms, particularly tremors. Larger studies are needed, however, before the effects of this PRNP gene variation on Wilson disease can be established.

Related Gene(s)

Changes in these genes are associated with Wilson disease.

  • ATP7B
  • PRNP

How do people inherit Wilson disease?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of Wilson disease?

These resources address the diagnosis or management of Wilson disease and may include treatment providers.

  • Gene Review: Wilson Disease (http://www.ncbi.nlm.nih.gov/books/NBK1512)
  • Genetic Testing Registry: Wilson's disease (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0019202)
  • MedlinePlus Encyclopedia: Wilson's disease (http://www.nlm.nih.gov/medlineplus/ency/article/000785.htm)
  • National Human Genome Research Institute (http://www.genome.gov/27532725)

You might also find information on the diagnosis or management of Wilson disease in Educational resources and Patient support.

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about Wilson disease?

You may find the following resources about Wilson disease helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for Wilson disease?

  • copper storage disease
  • hepatolenticular degeneration syndrome
  • WD
  • Wilson's disease

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about Wilson disease?

Ask the Genetic and Rare Diseases Information Center (https://rarediseases.info.nih.gov/gard).

What glossary definitions help with understanding Wilson disease?

amino acid ; anxiety ; autosomal ; autosomal recessive ; cell ; cornea ; depression ; gene ; inherited ; jaundice ; Kayser-Fleischer ring ; methionine ; nervous system ; neurological ; prion ; protein ; recessive ; syndrome ; teenage ; toxic ; valine

You may find definitions for these and many other terms in the Genetics Home Reference Glossary.

References

  • Aggarwal A, Bhatt M. Update on Wilson disease. Int Rev Neurobiol. 2013;110:313-48. doi: 10.1016/B978-0-12-410502-7.00014-4. Review. (http://www.ncbi.nlm.nih.gov/pubmed/24209444?dopt=Abstract)
  • Coffey AJ, Durkie M, Hague S, McLay K, Emmerson J, Lo C, Klaffke S, Joyce CJ, Dhawan A, Hadzic N, Mieli-Vergani G, Kirk R, Elizabeth Allen K, Nicholl D, Wong S, Griffiths W, Smithson S, Giffin N, Taha A, Connolly S, Gillett GT, Tanner S, Bonham J, Sharrack B, Palotie A, Rattray M, Dalton A, Bandmann O. A genetic study of Wilson's disease in the United Kingdom. Brain. 2013 May;136(Pt 5):1476-87. doi: 10.1093/brain/awt035. Epub 2013 Mar 21. (http://www.ncbi.nlm.nih.gov/pubmed/23518715?dopt=Abstract)
  • Das SK, Ray K. Wilson's disease: an update. Nat Clin Pract Neurol. 2006 Sep;2(9):482-93. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16932613?dopt=Abstract)
  • Ferenci P. Pathophysiology and clinical features of Wilson disease. Metab Brain Dis. 2004 Dec;19(3-4):229-39. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15554419?dopt=Abstract)
  • Gitlin JD. Wilson disease. Gastroenterology. 2003 Dec;125(6):1868-77. Review. (http://www.ncbi.nlm.nih.gov/pubmed/14724838?dopt=Abstract)
  • Kitzberger R, Madl C, Ferenci P. Wilson disease. Metab Brain Dis. 2005 Dec;20(4):295-302. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16382340?dopt=Abstract)
  • Langner C, Denk H. Wilson disease. Virchows Arch. 2004 Aug;445(2):111-8. Epub 2004 Jun 17. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15205951?dopt=Abstract)
  • Pandit A, Bavdekar A, Bhave S. Wilson's disease. Indian J Pediatr. 2002 Sep;69(9):785-91. Review. (http://www.ncbi.nlm.nih.gov/pubmed/12420912?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: January 2014
Published: September 1, 2015