Wilson's disease and pregnancy

Wilson's disease is an autosomal recessive disorder of copper metabolism. Since the introduction of penicillamine treatment successful pregnancies have been reported. However little is known about the risks of breast feading in patients on this medication. We describe the case of a patient suffering from Wilson's disease, who had two uncomplicated pregnancies and breast fed both children for a period of three months each. In the 22 year old gravida I para I the diagnosis of Wilson's disease had been previously made by liver biopsy and penicillamin therapy had been begun. At the time of her first presentation at our department she was 8 weeks pregnant. Her renal and liver function were normal. Neurologic or psychiatric symptoms were not observed. At 18 weeks the dosage of penicillamin was reduced from 900 mg/d to 750 mg/d. The course of the pregnancy remained uneventful. At 38+1 weeks a healthy boy of 3100 gm was delivered. 19 months later the patient presented again in the 16th week of her second pregnancy. Concerning Wilson's disease no major changes were observed, especially liver and renal function were not impaired. The dosage of penicillamin was reduced from 900 mg/d to 750 mg/d during the 21st week. The pregnancy again was uncomplicated and at 38+2 weeks resulted in the spontaneous delivery of a healthy boy, weighing 3940 gm. Both children were breast fed over a period of three months and with the exception of an icterus prolongatus no advers effects were noted.