A 16-year-old boy presents with dystonia, dysarthria, and behavioral changes. Slit-lamp examination reveals Kayser-Fleischer rings. Serum ceruloplasmin is low. What is the recommended initial chelation therapy?
- A Zinc acetate monotherapy
- B Trientine monotherapy
- C D-penicillamine ✓
- D Deferoxamine
Correct answer: C. D-penicillamine
Explanation
Wilson's disease presents with neuropsychiatric symptoms, Kayser-Fleischer rings, and low ceruloplasmin. D-penicillamine is the traditional first-line chelating agent. Trientine is an alternative, often used if penicillamine is not tolerated. Zinc is used for maintenance or presymptomatic patients. Deferoxamine is for iron overload.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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