A 24-year-old man presents with new-onset dysarthria, tremor, behavioral changes, and difficulty writing. Vital signs show BP 118/76, HR 88, RR 16, temp 37°C, SpO2 98%. Examination reveals cogwheel rigidity and a characteristic wing-beating proximal upper extremity tremor. Slit-lamp examination demonstrates brown Kayser-Fleischer rings at the corneal periphery. Serum ceruloplasmin level is decreased at 18 mg/dL (normal >20). No hepatomegaly is noted. Which of the following is the most likely underlying disorder?
- A)Spinocerebellar ataxia
- B)Wilson diseaseGABARITO
- C)Huntington disease
- D)Parkinson disease
- E)Essential tremor
Explicação
Wilson disease causes copper accumulation in the liver, basal ganglia, and cornea leading to tremor, dystonia, psychiatric changes, and Kayser-Fleischer rings. Ver explicação completa e trilha adaptativa →