Professional paper
https://doi.org/10.2478/10004-1254-62-2011-2102
Work Ability Assessment in a Patient with Wilson’s Disease
Martin B. Popević
; University of Belgrade School of Medicine, Belgrade, Serbia
Gordana Kisić
; Serbian Institute for Occupational Health, Belgrade, Serbia
Milenko Đukić
; Serbian Institute for Occupational Health, Belgrade, Serbia
Petar Bulat
; University of Belgrade School of Medicine, Belgrade, Serbia
Abstract
Wilson’s disease (WD) is a rare, progressive autosomal recessive disorder characterised by impaired transport and excessive accumulation of copper in the liver, brain, and other tissues. The disease is diagnosed based on clinical manifestations and screening tests results. Work ability assessment of patients with WD is based on the analysis of liver, kidney, neurological, and cognitive impairments, and takes into account patient’s level of education. This article presents a case with a 48-year-old male patient, who was admitted for work ability assessment due to polymorphic symptoms. The patient had been working as a salesman for 28 years. A detailed interview and examination by occupational health and other medical specialists revealed that the patient had been suffering from Wilson’s disease from the age of 13, and had now developed hepatic manifestations (compensated liver cirrhosis with portal hypertension), neurological manifestations (dystonia, dysarthria, muscle weakness, vertigo), and psychiatric manifestations (depression, insomnia, cognitive impairment) of the disease, including problems partially caused by long-lasting treatment with copper chelating agents (neurological and haematological manifestations). There were no ocular manifestations of Wilson’s disease (Kayser-Fleischer rings or sunflower cataract). The patient was assessed as having drastically diminished general work ability, dominantly due to neurological and psychiatric impairments caused by Wilson’s disease.
Keywords
chelation therapy; cognitive impairment; copper; depression; disability evaluation; Dpenicillamine; dysarthria; dystonia; insomnia; Kayser-Fleischer rings; liver cirrhosis; muscle weakness; portal hypertension; psychiatric disorders; vertigo
Hrčak ID:
69305
URI
Publication date:
17.6.2011.
Visits: 3.094 *