Zinc Therapy of Wilson Disease

Zinc was introduced in 1961 as an alternative for chelators in the treatment of Wilson disease by the Dutch neurologist Schouwink. He had learned from the literature that high dosages of zinc could be used to treat copper intoxication in sheep and therefore started using this medication in two patients. When Hoogenraad, another Dutch neurologist, reexamined one of these patients after 14 years of continuous zinc therapy, it turned out that he was symptom-free and that the Kayser-Fleischer Rings that were present earlier had disappeared. Given this observation and the lack of side effects, he started to treat more patients with zinc and communicated the results in several articles. The possible advantages of zinc therapy over chelators were soon picked up by several other groups, notably Brewer from the United States, Czlonkowska from Poland, and subsequently others. Consequently, a vast amount of data are now available, which allows us to give good overview of zinc therapy in Wilson disease.