Referral-spectrum Effect in Hypercupriuric Referrals for Suspected Wilson Disease: Diagnostic Implications for Ceruloplasmin and 24-hour Urinary Copper Excretion (IMAGE)
Caption
In patients referred because of hypercupriuria, the diagnostic interpretation of copper biomarkers is strongly context-dependent. In this referral setting, 24-h UCE had limited standalone discriminatory utility, whereas Cp retained strong diagnostic performance. Nevertheless, 24-h UCE remains clinically relevant when interpreted in biochemical context rather than in isolation. A Leipzig-aligned Cp three-zone framework may provide a practical basis for probability-based triage and targeted ATP7B testing, while preserving the need for integrated diagnostic assessment when clinical suspicion persists.
Credit
Yongfeng Yang, Shasha Li
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CC BY-NC