Evaluation of patients with suspected Wilson disease but no Kayser-Fleischer rings

This algorithm summarizes an approach to evaluating for Wilson disease in patients with liver-related symptoms (eg, elevated aminotransferases, low alkaline phosphatase, hepatomegaly) but no Kayser-Fleischer rings. Wilson disease may be suspected because liver findings are unexplained and/or accompanied by neurologic or psychiatric symptoms. This algorithm is intended for use in conjunction with UpToDate content on the clinical features and diagnosis of Wilson disease.