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?

  1. A)Spinocerebellar ataxia
  2. B)Wilson diseaseGABARITO
  3. C)Huntington disease
  4. D)Parkinson disease
  5. 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 →

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