Copper accumulation begins at birth but it may take several decades or more before the liver is overwhelmed and the symptoms of liver disease begin to appear. Symptoms usually appear between the ages of 6 and 40, most commonly in late adolescence or teens.
Symptoms can range from jaundice (a yellowing of the skin and whites of the eyes) to acute liver failure and may include:
- abdominal pain (in the ‘tummy’ or ‘belly’ area between the chest and pelvis)
- swelling caused by fluid in the abdomen (ascites)
- vomiting blood (from bleeding varices).
The toxic effects of copper accumulation on the nervous system can lead to a range of disabling physical symptoms, most obviously:
- clumsiness and loss of physical coordination
- loss of muscle control
- contractions
- distorted posture, twisting and repetitive gestures
- slowness of movement (bradykinesia)
- tremors in the arms, legs and head.
The disease may cause problems with language and speech including:
-
a failing voice, slurring, drooling
-
difficulty in swallowing
-
loss of memory and mental confusion.
Around a third of people with Wilson’s disease may experience psychiatric symptoms such as:
- personality change
- uncharacteristic, possibly bizarre behaviour
- worry or anxiety (neurosis)
- depression and mood swings
- suicidal or homicidal thoughts
- delusions or hallucinations (psychosis).
A characteristic clinical sign of Wilson’s disease is a rusty or coppery brown ring around the cornea of your eye, known as the Kayser-Fleischer ring. These rings are not always visible to the naked eye and are only present in around 50% of people with the disease.