Best diagnostic test for Wilson disease

Tests and procedures used to diagnose Wilson's disease include: Blood and urine tests. Blood tests can monitor your liver function and check the level of a protein that binds copper in the blood (ceruloplasmin) and the level of copper in your blood What tests do doctors use to diagnose Wilson disease? Doctors typically use blood tests and a 24-hour urine collection test to diagnose Wilson disease. Doctors may also use a liver biopsy and imaging tests The cut-offs used for caeruloplasmin, 24-hour urinary copper and hepatic copper for diagnosing Wilson's disease are method-dependent and require validation in the population in which such index tests are going to be used. Binary cut-offs and use of single-test strategies to rule Wilson's disease in Serious neurological and liver damage can be prevented by early diagnosis and treatment. The diagnostic tests for Wilson disease are done on blood (serum) and urine samples. Wilson disease is suspected in individuals with low blood (serum) copper levels and low blood (serum) ceruloplasmin levels

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ric disease: renal abnormalities including aminoaciduria and nephrolithiasis,27-29 skeletal abnormalities such as premature osteoporosis and arthritis,30 cardiomyopa-Fig. 1. Approach to diagnosis of Wilson disease (WD) in a patient with unexplained liver disease. Molecular testing means confirming homozygosit The following tests may be used to diagnose and/or monitor treatment: Ceruloplasmin - the result is usually decreased with Wilson disease, but about 5% of those affected who have nervous system symptoms will have normal ceruloplasmin levels as will up to 40% of those with liver symptoms

Wilson's disease - Diagnosis and treatment - Mayo Clini

Wilson's Disease: The Copper Connection Table 2. Limitations of Diagnostic Tests for Wilson's Disease Test Pros Cons Physical examination • Inexpensive • Specific findings (i.e. KF rings, abnormal neuro exam, skin/nail findings) help support diagnosis • May be normal (particularly if asymptomatic) • No pathognomonic PE findings. Clinical presentation of Wilson disease can vary widely; therefore diagnosis is not always straightforward. Wilson disease is not just a disease of children and young adults, but may present at any age. The key features of Wilson disease are liver disease and cirrhosis, neuropsychiatric disturbances WDZ : Wilson disease (WD) is an autosomal recessive disorder that results from the body's inability to excrete excess copper. Typically, the liver releases excess copper into the bile. Individuals with WD lack the necessary enzyme that facilitates clearance of copper from the liver to bile. As a result, copper accumulates first in the liver and gradually in other organs

Listed below are the standard laboratory tests used to diagnose Wilson's disease: Urine copper is high; this should be measured in a 24 hour urine collection. Caeruloplasmin, a copper-containing protein in blood plasma is usually low. The copper concentration measured in a liver biopsy specimen will be high Latest news about Best Diagnostic Test For Wilson Disease for you to update health information Doctors typically use blood tests and a 24-hour urine collection test to diagnose Wilson disease. Doctors may also use a liver biopsy and imaging tests Screening and diagnostic tests: 24-hour urine copper measurement, ophthalmologic slit-lamp examination for Kayser-Fleischer (KF) rings, blood ceruloplasmin levels, and liver biopsy with measurement of quantitative copper. Unlike many genetic disorders, it is treatable Wilson's Temperature Syndrome is largely a diagnosis of exclusion and is best confirmed with a good response to a therapeutic trial. What does that mean? It means that there are several identifiable medical conditions that can cause symptoms similar to Wilson's Temperature Syndrome that can be easily ruled out or excluded with simple tests

The presence of Kayser-Fleischer rings and ceruloplasmin levels of less than 20 mg/dL in a patient with neurologic signs or symptoms suggest a diagnosis of Wilson disease BACKGROUND Wilson's disease is a rare but treatable condition that often presents diagnostic dilemmas. These dilemmas have for the most part not been resolved by the identification and cloning of the Wilson's disease gene. AIMS To report our experience over three decades with patients with Wilson's disease in order to illustrate the diverse patterns of presentation and thereby broaden the.

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Screening for Wilson disease (WD) in sibling or child of a patient with secure diagnosis of WD. If molecular testing is available in the index patient, then this is the most efficient screening strategy. If initial screening by blood and urine testing is normal, then consider repeat screening in 2-5 years Wilson disease is a disorder of copper metabolism. Patients suspected of having Wilson disease often have liver disease (40%), neurologic disease (40%), and psychiatric disturbance (20%); most have the eye finding of Kayser Fleischer rings. Diagnosis can occur during a wide range of ages; most often, it is between 6 and 50 years of age The diagnosis of WD should be based upon evidence derived from the patient's history, family history, physical exam including neurologic exam, laboratory tests for liver disease, ceruloplasmin and..

There is no completely reliable test for Wilson disease, but levels of ceruloplasmin and copper in the blood, as well as copper excreted in urine during a 24-hour period, are used to form an impression of the amount of copper in the body. The gold standard is a liver biopsy. First and second-degree relatives need to be screened for Wilson disease Wilson's disease diagnosis. Diagnosing Wilson's disease can be challenging because its signs and symptoms are often hard to tell from those of other liver diseases, such as hepatitis. Also, symptoms can evolve over time. Behavioral changes that come on gradually can be especially hard to link to Wilson's Wilson's disease is an autosomal-recessive disease of copper accumulation and toxicity caused by a defect in an enzyme involved in the biliary excretion of excess copper. Affects up to 1 in 40,000 people. Diagnosis often missed; should be considered in patients aged 10 to 40 years with hepatitis,.. What genetic testing is currently available for Wilson disease? The sequence analysis of ATP7B gene (Wilson disease gene) to identify the mutations is clinically available as a test. Although this is the most updated and thorough test, please be aware that some alterations such as large deletion or duplication may not be detected with this method Intrahepatic copper is considered the best biochemical test for Wilson's disease [1, 2]. All our patients presented with an intrahepatic copper content >250 μg/g. Another instrument that was shown to provide good diagnostic accuracy in the diagnosis of Wilson's disease is the Leipzig score . It is based on clinical symptoms and signs.

Biomarkers for diagnosis of Wilson's diseas

  1. The diagnosis of Wilson's disease was judged to be improbable for scores between zero and one. With respect to molecular analysis, it should be noted that more than 200 different mutations have been identified. It has been difficult to devise a simple genetic screening test for the disease. Thus only the H1069Q (exon 14), was researched
  2. A diagnostic score based on all available tests was proposed by the Working Party at the 8th International Meeting on Wilson's disease, Leipzig 2001 (Ferenci et al., 2003; Table 14.3 and Fig. 14.1) and adopted in the European Association for the Study of the Liver clinical practice guidelines for Wilson disease (European Association for the.
  3. Wilson disease is an autosomal recessive disorder of copper metabolism caused by mutations in the ATP7B gene. An early diagnosis is crucial to prevent evolution of the disease, as implantation of early therapeutic measures fully prevents its symptoms. As population genetics data predict a higher than initially expected prevalence, it was important to define the basic diagnostic tools to.
  4. ant Wilson's disease is the preponder-ance of females (female to male ratio, 3 : 1). Chronic hepatitis and cirrhosis due to Wilson's disease Wilson's disease may present with a clinical syndrom
  5. ation for Kayser-Fleischer rings. Serum ceruloplas
  6. levels, and so at that point a 24-hour urine sample was ordered as well as a genetic test for Wilson Disease. The analysis of my 24-hour urine sample revealed abnormally low levels of copper, but the genetic test came back negative
  7. istration (FDA) to make.

Objective To systematically review methods developed and employed to evaluate the diagnostic accuracy of medical test when there is a missing or no gold standard. Study design and settings Articles that proposed or applied any methods to evaluate the diagnostic accuracy of medical test(s) in the absence of gold standard were reviewed. The protocol for this review was registered in PROSPERO. A 24-hour urine test to determine the amount of copper in your urine over a 24-hour period A liver biopsy, which involves obtaining a small sample of your liver for testing to confirm a diagnosis and determine the severity of liver disease Genetic testing (by blood test) to identify the abnormal genes that cause Wilson's disease This test is regarded as the criterion standard for diagnosis of Wilson disease. A liver biopsy with sufficient tissue reveals levels of more than 250 mcg/g of dry weight even in asymptomatic patients Candidates for this test are patients with a clinical diagnosis of Wilson disease. Patients must reside in the US or Canada. Patients cannot have had previous ATP7B genetic testing, unless previous testing only found one variant in the gene, or was negative.; Patients must have two of the following clinical features A hepatic copper concentration greater than 250 μg/g dry weight is usual in homozygous Wilson's disease and with some caveats remains the best biochemical test for the disease. Measurement of copper content in liver is the most important diagnostic test in patients in whom other data are suggestive but not diagnostic of disease

Diagnosis. Wilson's disease can be challenging to diagnose. Experience and the most advanced testing techniques help Mayo Clinic doctors make timely and accurate diagnoses. Treatment. Promising research in regenerative medicine is underway for cellular therapy for certain metabolic liver diseases, such as Wilson's disease Purpose of Review Exciting developments relating to Wilson disease (WD) have taken place with respect to both basic biological and clinical research. This review critically examines some of these findings and considers their implications for current thinking about WD. It is not a comprehensive review of WD as a clinical disorder. Recent Findings The structure of the gene product of ATP7B. The following are examples of diagnostic tests: Cardiac stress test to look for heart disease in a person with chest pain. Chest X-ray to look for pneumonia in a person with a cough and fever. Complete blood count to look for anemia in a person with fatigue. Breast biopsy in a person with an abnormal screening mammogram Analysis of 24 h copper excretion in urine is an easy and important diagnostic test for Wilson's disease. Acid-washed (copper-free) collection containers should be used. Urinary copper excretion greater than 100 μg per 24 h, in the absence of cholestatic liver disease, is typical for Wilson's disease Possible Wilson's? Does Wilson's Disease patients need a two year Endoscopy? Could it be Wilson's Disease? Do these levels seem normal for zinc therapy for wilson's disease? Frontal Lobe Damage caused from Wilson's Disease; Do these symptoms sound like Wilson's? Could I have Wilson's Disease? Waiting for KF test, Wilson's likel

Diagnosis and Testing: How do I get tested for Wilson

  1. Despite all the advances we still have to consider the diagnosis of Wilson disease to test patients for this disorder and properly establish the diagnosis before committing to life-long treatment.
  2. Ataxia and Dysarthria: A Case of Neurologic Wilson's Disease Kristen Olinger, Gan Xon Ng, M.D., Hassana Ibrahim, M.D. Case Report. A 39-year-old Asian female with a past medical history of Wilson's disease, hypertension, and chronic low back pain presented to the emergency room with lower extremity weakness, dysarthria and gait disturbance
  3. Genetic testing also has a role in the diagnosis of Wilson disease, but because of the large number of mutations seen in Wilson disease, it is generally reserved for those in whom a diagnosis cannot be established in other ways, or to screen family members when the mutation in ATP7B in the proband is known
  4. The best indicator that a person's MED was caused by Wilson's Temperature Syndrome is if all of the symptoms resolved in a short period of time (often within two days or two weeks) when the body temperature patterns were normalized by the patient taking the right kind of thyroid medicine (Chapter 10) in the right way, and if the symptoms.
  5. ant Wilson's disease (FWD). In this study, we aimed to develop an early, simple and accurate diagnostic method to differentiate FWD from nonwilsonian acute liver failure.

Caeruloplasmin- requested to help diagnose Wilson's disease. Its level is usually decreased but about 5% of patients with Wilson's disease who have neurological symptoms will have normal caeruloplasmin levels as will up to 40% of those with liver symptoms. Total serum copper - may be requested to help diagnosis, but it is of limited use. Wilson disease is a rare genetic disorder characterized by excess copper stored in various body tissues, particularly the liver, brain, and corneas of the eyes. The disease is progressive and, if left untreated, it may cause liver (hepatic) disease, central nervous system dysfunction, and death. Early diagnosis and treatment may prevent serious. Wilson's disease is an autosomal-recessive disorder of copper metabolism caused by mutations in ATP7B and associated with neurological, psychiatric, ophthalmological and hepatic manifestations. Decoppering treatments are used to prevent disease progression and reduce symptoms, but neurological outcomes remain mixed. In this article, we review the current understanding of pathogenesis. Because many laboratory tests are inconclusive in patients with less advanced disease, and because the gold standard liver biopsy is an invasive and high cost procedure, the non-invasive evaluation for a Kayser-Fleischer ring is still an essential part of the diagnostic work up for Wilson's disease Wilson Disease. Test Description: Wilson disease is a disorder caused by mutations in the gene ATP7B, which encodes a protein that plays a role in copper transport. Mutations in this gene result in the toxic accumulation of copper in different tissues in the body, particularly the liver and the nervous system

  1. If the diagnosis is uncertain the definitive diagnostic test is a liver biopsy with quantitative assay of copper (normal is 20 to 50 micrograms/g dry weight of tissue: in Wilson's disease the level is >200 micrograms/g). Absence of copper stain on the liver tissue does not rule out Wilson's disease
  2. (the protein which transports copper through the blood
  3. Therefore, in patients with suspected Wilson's disease, copper quantification performed on either a dedicated core-biopsy specimen or a paraffin-embedded tissue sample is considered to be the best available diagnostic test
  4. Wilson disease (WD) is an autosomal recessive disorder of copper transport which maps to chromosome 13q14.3. In pursuit of the WD gene, we developed yeast artificial chromosome and cosmid contigs.

Wilson's disease may be considered in any child over three years of age who has acute or chronic liver disease. If it is suspected that a child or a young person may have Wilson's disease then there are a number of tests which can be used to confirm the diagnosis The test will look for several markers of Lyme disease to ensure accuracy. You can also choose from five different panels of testing. Some of these panels, for example, look at T cells, antibodies. Wilson's disease, the most common inherited disorder of copper metabolism, is a recessive genetic condition. The clinical presentation of Wilson's disease is very variable. It is characterised by low serum copper and caeruloplasmin concentrations coupled with the pathological accumulation of copper in the tissues. However, there are diagnostic difficulties and these are discussed Wilson disease is a rare inherited disorder that is characterized by the accumulation of copper in the body. Because high levels of copper are toxic to tissues and organs, this buildup can lead to damage of the liver, brain and eyes.Signs and symptoms of Wilson disease include chronic liver disease, central nervous system abnormalities, and psychiatric (mental health-related) disturbances

A screening test is not intended to be diagnostic. Persons with positive or suspicious findings must be referred to their physicians for diagnosis and necessary treatment.l It should be noted that, by definition, unrecognized symptomatic as well as pre-sympto- matic disease is included; also, physical examination is considered par Wilson Disease Definition Wilson disease, or WD, is a rare inherited disorder that causes excess copper to accumulate in the body. It is also known as hepatolenticular degeneration. Steadily increasing amounts of copper circulating in the blood are deposited primarily in the brain, liver, kidneys, and the cornea of the eyes. WD is fatal if it is not. These tests can also help your doctor identify any complications from Wilson's disease like fatty liver or liver cirrhosis to develop the best treatment plan for you. Treatment usually involves taking medications that lower copper levels by increasing the elimination of copper from the body or by reducing its absorption from food Wilson's disease is an autosomal-recessive disease of copper accumulation and toxicity caused by a defect in an enzyme involved in the biliary excretion of excess copper. Affects up to 1 in 40,000 people. Diagnosis often missed; should be considered in patients aged 10 to 40 years with hepatitis, cirrhosis, hepatic decompensation, and symptoms. Background and Aims: Cystic fibrosis-related liver disease (CFLD) is one of the leading causes of morbidity and mortality in cystic fibrosis (CF). Several non-invasive diagnostic methods have been proposed as screening tools for CFLD. Our aim was to rank all available non-invasive modalities for diagnostic performance.Methods: A systematic search was performed in five medical databases to find.

Wilson's disease is a condition where too much copper builds up in the body. It is a rare inherited disorder that affects about 1 in 30,000 people. It is named after Dr Samuel Wilson who first described the disorder in 1912. If you inherit the genetic fault in Wilson's disease, your body is not able to get rid of copper Wilsons disease. Wilson disease (WD) is a rare, but treatable, autosomal recessive disorder of hepatic copper disposition. Onset of clinical disease can occur at any age, though mainly between 3 and 55 years old. Age alone is not a reason for discounting the diagnosis of WD. WD can present as hepatic disease, neurological movement disorders, or. Ronald Wilson Reagan (/ ˈ r eɪ ɡ ən / RAY-gən; February 6, 1911 - June 5, 2004) was an American politician who served as the 40th president of the United States from 1981 to 1989 and became a highly influential voice of modern conservatism.Prior to his presidency, he was a Hollywood movie actor and union leader before serving as the 33rd governor of California from 1967 to 1975

Diagnosis - Wilson's Diseas

likelihood ratio of 7 for diagnosing fulminant Wilson's disease, and when the tests were combined, the diagnostic sensitivity and specificity was 100% (Korman, 2008). The gold standard test for diagnosing Wilson's disease is measuring hepatic copper content on a liver biopsy. According to Ferenci et al. a copper content of >250 µg/g dry weigh The diagnosis of PD is made clinically, and in cases without atypical features no additional diagnostic testing is indicated. If diagnostic testing is warranted due to atypical features or unclear clinical diagnosis, tests may include serum ceruloplasmin. In all younger patients (<40 years), a diagnosis of Wilson disease should be excluded

Find the best doctors for Wilson's Disease in Toba Tek Singh. Book in-person or online video appointments with the help of up to date practice locations, reviews and fees and save upto 50% T1 - Screening for Wilson disease in acute liver failure. T2 - A comparison of currently available diagnostic tests. AU - Korman, Jessica D. AU - Volenberg, Irene. AU - Balko, Jody. AU - Webster, Joe. AU - Schiodt, Frank V. AU - Squires, Robert H. AU - Fontana, Robert J. AU - Lee, William M. AU - Schilsky, Michael L. AU - Polson, Juli

Wilson disease: Diagnostic tests - UpToDat

A ceruloplasmin test is most often used, along with copper testing, to help diagnose Wilson disease. Wilson disease is a rare genetic disorder that prevents the body from removing excess copper. It can cause a dangerous buildup of copper in the liver, brain, and other organs. It may also be used to diagnose disorders that cause a copper. Wilson disease is a genetic disorder that prevents the body from removing extra copper, causing copper to build up in the liver, brain, eyes, and other organs. Without treatment, high copper levels can cause life-threatening organ damage Learning points. Wilson disease (WD) poses a diagnostic challenge because serum ceruloplasmin may be elevated to a value within normal range since it is an acute phase reactant, and patients with liver failure regardless of aetiology may present with an elevated 24-hour urine copper and a low ceruloplasmin

Wilson disease (WD) is an autosomal recessive disorder of copper transport which map to chromosome 13q14.3, characterized by the toxic accumulation of copper in a number of organs, particularly the liver and brain [1,2]. Named after the Samuel Kinnear Wilson who identified it in 1912, WD disease is also known as hepatolenticular degeneration There is no cure for Wilson disease. However, with genetic counseling, you might be able to determine whether your current or future children are at risk of developing it. Your health care provider may recommend genetic testing, if there is a strong family or personal history of the condition Wilson disease (WD), also known as hepatolenticular degeneration, is an autosomal recessive disorder of human copper metabolism, 1,2 caused by pathogenic variants in the copper-transporting gene ATP7B. 3 ⇓ -5 WD leads to intracellular copper accumulation, causing damage to many organs, especially the brain. 6 ⇓ -8 Neurologic WD is one of the main forms of the disease, with some. Diagnosis and Tests. Wilson's disease is almost certainly the diagnosis in any patient presenting with fulminant hepatitis, Coombs-negative hemolytic anemia, ceruloplasmin deficiency, and hypercupriuria. Unless Wilson's disease is suspected, its diagnosis is often missed because of its rarity. It should be suspected in a person under the age of. 2 Wilson's Disease Symptoms. 3 Liver problems. 3.1 Neuropsychiatric problems. 3.2 Eye, Kidney and Bone problems. 3.3 Heart Problems. 3.4 Hormonal Problems. 4 Wilson's Disease Diagnosis. 4.1 Blood and Urine Tests. 4.2 Liver Biopsy

Measuring the parenchymal copper concentration is the sine qua non for the diagnosis of Wilson disease. Hepatic copper concentration (criterion standard) on a liver biopsy specimen is >250 mcg/g of dry weight even in asymptomatic patients. A normal result (15-55 mcg/g) effectively excludes the diagnosis of untreated 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 Wilson disease (hepatolenticular degeneration) is an. autosomal recessive. metabolic disorder in which impaired copper excretion causes copper to accumulate in the body. In its initial stages, Wilson disease leads to copper deposits in the liver. As the disease progresses, copper also accumulates in other organs, most importantly in the brain and

Wilson Disease Lab Tests Onlin

Wilson disease has symptoms that mirror or look like many other disorders. Liver disease associated with Wilson disease can mimic the symptoms of viral hepatitis. Your doctor can tell the difference by doing viral antigen studies as well as copper testing studies. Alcoholic cirrhosis is anothe The chart below shows the chance of inheriting Wilson disease from parents who are carriers. The mutations that cause Wilson disease are autosomal recessive, meaning that a person must inherit two genes with mutations to have Wilson disease. References [7] Schilsky ML. Wilson disease: diagnostic tests. UpToDate

Acute liver failure (ALF) due to Wilson disease (WD) is invariably fatal without emergency liver transplantation. Therefore, rapid diagnosis of WD should aid prompt transplant listing. To identify the best method for diagnosis of ALF due to WD (ALF-WD), data and serum were collected from 140 ALF patients (16 with WD), 29 with other chronic. It is best to separate testing appropriate for the acute hepatitis situation from testing for chronic liver disease caused by hepatitis B. Only a few tests need to be considered by the generalist to determine the status of a patient with possible hepatitis B. A practical algorithm on the diagnostic tests for Wilson disease in shown in Table. Wilson disease (WD) is a potentially treatable, inherited disorder of copper metabolism that is characterized by the pathological accumulation of copper. WD is caused by mutations in ATP7B, which.

It is best to separate testing appropriate for the acute hepatitis situation from testing for chronic liver disease caused by hepatitis B. Only a few tests need to be considered by the generalist to determine the status of a patient with possible hepatitis B. Table 9: Diagnostic Tests for Wilson Disease 11. Level 1 Tests Level 2 Tests Level. Wilson disease is a rare genetic condition that affects about one in 30,000 people. Wilson disease causes a person's body to store too much of the mineral copper. Many foods contain copper, and it is important for people to have a small amount of copper in the body. However, high levels of copper can damage organs in the body Mowat-Wilson syndrome (MWS) is a rare genetic disorder that may be apparent at birth or later in childhood. MWS is characterized by intellectual disability, distinctive facial features and seizures. Other congenital anomalies occur in some individuals and can include a gastrointestinal disease known as Hirschsprung disease (40-50% of. Laboratory Testing Diagnosis. A combination of copper, free copper (direct), and ceruloplasmin testing is preferred to diagnose conditions of copper overload in symptomatic patients or individuals with a family history of Wilson disease. For diagnostic testing recommendations specific to Wilson disease, see the ARUP Consult Wilson Disease topic

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Wilson's disease is an inherited genetic disorder that causes an excess of copper to build up in the liver. The body obtains copper from food to develop nerves, bones, and the skin pigment melanin. However, excess copper is poisonous to the body. When excess copper exceeds the liver's capacity, the excess flows into the bloodstream and. For those individuals with a family history of Wilson's Disease, genetic testing may be helpful in making a diagnosis. A DNA mutation analysis blood test can identify the genetic mutations that cause Wilson's Disease thereby allowing asymptomatic family members to be tested and treated early before disabling symptoms begin In those symptomatic of Wilson's disease, a urinary copper excretion in a 24-h period of >1.6 μmol (>100 μg/24 h) is considered diagnostic of the disease, 55 with levels >0.6 μmol (>40 μg/24 h) as the better threshold for diagnosis because it improved sensitivity in testing for the disease. 50 A penicillamine challenge study may still be. To identify the best method for diagnosing ALF due to Wilson disease, researchers performed a nested, case-control study using data from the Acute Liver Failure Study Group registry, which comprises more than 1050 patients with ALF. A total of 16 patients with ALF due to Wilson disease were identified between 1998 and 2004 Disease that presents early in life has the worst prognosis than that which presents later in life. Wilson's Disease has been diagnosed in children as young as 3 to 5 years. If the patient stops.


Genetic metabolic diseases such as hemochromatosis, Wilson disease, and α 1-antitrypsin deficiency are screened with testing for transferrin saturation, serum ceruloplasmin, and α 1-antitrypsin phenotype, respectively. In case of elevated transferrin saturations, a genetic test for hemochromatosis can be performed, depending on the clinical. unrecognized disease or defect by the application of tests, examinations, or other procedures which can be applied rapidly. Screening tests sort out apparently well persons who probably have a disease from those who probably do not. A screening test is not intended to be diagnostic Diagnosis of the classic form of Graves' disease is easy and depends on the recognition of the cardinal features of the disease and confirmation by tests such as TSH and FTI. The differential diagnosis includes other types of thyrotoxicosis, such as that occurring in a nodular gland, accompanying certain tumors of the thyroid, or thyrotoxicosis factitia, and nontoxic goiter Therefore, a simple, rapid and diagnostic test is required for WD, ideally to identify patients before symptoms appear. First symptoms have been reported in patients as young as 2 years of age . Thus screening tests for WD at least at the age of 2 years would be appropriate. Penetrance of disease is expected to be 100% When suspicion remains or ceruloplasmin level is low, other tests such as 24 urine collection for copper, slit-lamp eye examination for Kayser-Fleischer rings, serum copper levels, and genetic testing of the ATP7B gene are indicated as outlined in diagnostic guidelines for diagnosing Wilson disease . Budd-Chiari syndrome may sometimes mimic.