{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:59:37Z","timestamp":1785517177255,"version":"3.56.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["220211"],"award-info":[{"award-number":["220211"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Wilson\u2019s disease, an autosomal recessive disorder, affects body copper metabolism. It can be fatal if left untreated as the copper accumulation ultimately leads to liver failure, brain damage, or both. In women discontinuation of menstruation, miscarriage and impaired conception can be symptoms of Wilson\u2019s disease. Successful pregnancies in untreated patients with major symptoms are rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 30-year-old, gravidity 5, parity 4, Karen woman presented, after travelling for more than 5 h to a clinic on the Thailand\u2013Myanmar border. Over the course of a year she progressively lost the ability to walk, sit or drink by herself. Kayser\u2013Fleischer rings were present along with a 7-month pregnancy. Oral zinc was commenced based on a provisional diagnosis of Wilson\u2019s disease, and later switched to D-penicillamine when it could be sourced. After birthing a healthy term female baby, mum required an assistant to secure and maintain attachment for breastfeeding. After 1 year of follow-up most of the symptoms had resolved and the baby was thriving.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A thorough physical examination remains essential for neurological presentations in resource-limited and conflict-affected settings remains key to diagnosis and life-saving treatment, including for Wilson\u2019s disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13256-026-06273-8","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:15:03Z","timestamp":1784733303000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unable to walk or eat without assistance in pregnancy\u2014Wilson\u2019s disease in a resource-limited and conflict-affected setting: a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-8139","authenticated-orcid":false,"given":"Taco Jan","family":"Prins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nay Win","family":"Tun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung Myat","family":"Min","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Alison","family":"Stokes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"McGready","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"10","key":"6273_CR1","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1056\/NEJMra1903585","volume":"389","author":"EA Roberts","year":"2023","unstructured":"Roberts EA, Schilsky ML. Current and emerging issues in Wilson\u2019s Disease. N Engl J Med. 2023;389(10):922\u201338. https:\/\/doi.org\/10.1056\/nejmra1903585.","journal-title":"N Engl J Med"},{"key":"6273_CR2","doi-asserted-by":"publisher","unstructured":"Bandmann O, Weiss KH, Kaler SG. Wilson\u2019s disease and other neurological copper disorders. Vol. 14, The Lancet Neurology. Lancet Publishing Group; 2015. p. 103\u201313. https:\/\/doi.org\/10.1016\/S1474-4422(14)70190-5.","DOI":"10.1016\/S1474-4422(14)70190-5"},{"key":"6273_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2641-8","author":"XE Yu","year":"2019","unstructured":"Yu XE, Pan M, Han YZ, Yang RM, Wang J, Gao S. The study of Wilson disease in pregnancy management. BMC Pregnancy Childbirth. 2019;19(1). https:\/\/doi.org\/10.1186\/s12884-019-2641-8.","journal-title":"BMC Pregnancy Childbirth"},{"key":"6273_CR4","doi-asserted-by":"publisher","unstructured":"Mulligan C, Bronstein JM. Wilson Disease: An Overview and Approach to Management. Vol. 38, Neurologic Clinics. W.B. Saunders; 2020. p. 417\u201332. https:\/\/doi.org\/10.1016\/j.ncl.2020.01.005.","DOI":"10.1016\/j.ncl.2020.01.005"},{"issue":"3","key":"6273_CR5","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1002\/hep.20601","volume":"41","author":"A Ala","year":"2005","unstructured":"Ala A, Borjigin J, Rochwarger A, Schilsky M. Wilson disease in septuagenarian siblings: raising the bar for diagnosis. Hepatology. 2005;41(3):668\u201370. https:\/\/doi.org\/10.1002\/hep.20601.","journal-title":"Hepatology"},{"issue":"4","key":"6273_CR6","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1002\/hep.29490","volume":"67","author":"J Pfeiffenberger","year":"2018","unstructured":"Pfeiffenberger J, Beinhardt S, Gotthardt DN, Haag N, Freissmuth C, Reuner U, et al. Pregnancy in Wilson\u2019s disease: management and outcome. Hepatology. 2018;67(4):1261\u20139. https:\/\/doi.org\/10.1002\/hep.29490.","journal-title":"Hepatology"},{"issue":"6","key":"6273_CR7","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1034\/j.1600-0404.2000.90140a.x","volume":"101","author":"B Tarnacka","year":"2000","unstructured":"Tarnacka B, Rodo M, Cichy S, Cz\u0142onkowska A. Procreation ability in Wilson\u2019s disease. Acta Neurol Scand. 2000;101(6):395\u20138. https:\/\/doi.org\/10.1034\/j.1600-0404.2000.90140a.x.","journal-title":"Acta Neurol Scand"},{"issue":"7","key":"6273_CR8","doi-asserted-by":"publisher","first-page":"E32968","DOI":"10.1097\/MD.0000000000032968","volume":"102","author":"X Xiong","year":"2023","unstructured":"Xiong X, Wei H, Zhu Y, Zhou X, Zhao Z, Chen Q. Wilson disease in pregnancy: a case series. Medicine (United States). 2023;102(7):E32968. https:\/\/doi.org\/10.1097\/MD.0000000000032968.","journal-title":"Medicine (United States)"},{"issue":"1","key":"6273_CR9","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/0002-9378(93)90163-D","volume":"169","author":"M Oga","year":"1993","unstructured":"Oga M, Matsui N, Anai T, Yoshimatsu J, Inoue I, Miyakawa I. Copper disposition of the fetus and placenta in a patient with untreated Wilson\u2019s disease. Am J Obstet Gynecol. 1993;169(1):196\u20138. https:\/\/doi.org\/10.1016\/0002-9378(93)90163-D","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"6273_CR10","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/S0301-2115(00)00456-5","volume":"96","author":"B Furman","year":"2001","unstructured":"Furman B, Bashiri A, Wiznitzer A, Erez O, Holcberg G, Mazor M. Wilson\u2019s disease in pregnancy: five successful consecutive pregnancies of the same woman. Eur J Obst Gynecol Reprod Biol. 2001;96(2):232\u20134. https:\/\/doi.org\/10.1016\/S0301-2115(00)00456-5","journal-title":"Eur J Obst Gynecol Reprod Biol."},{"issue":"5","key":"6273_CR11","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1080\/15513815.2021.1960940","volume":"41","author":"MCL Mussi","year":"2022","unstructured":"Mussi MCL, Nardelli MJ, Santos BC, de Abreu ES, Os\u00f3rio FMF, Can\u00e7ado GGL, et al. Pregnancy outcomes in Wilson\u2019s Disease Women: single-center case series. Fetal Pediatr Pathol. 2022;41(5):741\u20138. https:\/\/doi.org\/10.1080\/15513815.2021.1960940.","journal-title":"Fetal Pediatr Pathol"},{"issue":"S2","key":"6273_CR12","doi-asserted-by":"publisher","first-page":"S56","DOI":"10.21037\/atm.2019.04.40","volume":"7","author":"U Reuner","year":"2019","unstructured":"Reuner U, Dinger J. Pregnancy and Wilson disease: management and outcome of mother and newborns\u2014experiences of a perinatal centre. Ann Transl Med. 2019;7(S2):S56\u2013S56. https:\/\/doi.org\/10.21037\/atm.2019.04.40.","journal-title":"Ann Transl Med"},{"key":"6273_CR13","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.reprotox.2016.06.015","volume":"65","author":"K Dathe","year":"2016","unstructured":"Dathe K, Beck E, Schaefer C. Pregnancy outcome after chelation therapy in Wilson disease. Evaluation of the German Embryotox Database. Reprod Toxicol. 2016;65:39\u201345. https:\/\/doi.org\/10.1016\/j.reprotox.2016.06.015","journal-title":"Reprod Toxicol"},{"key":"6273_CR14","doi-asserted-by":"publisher","unstructured":"Di Dato F, Hedera P. Zinc for Wilson\u2019s disease: what we know and what we don\u2019t know. Europ. Med. J. 2024;84\u201395. https:\/\/doi.org\/10.33590\/emj\/fumo2589","DOI":"10.33590\/emj\/fumo2589"},{"key":"6273_CR15","doi-asserted-by":"publisher","unstructured":"Linn FHH, Houwen RHJ, van Hattum J, van der Kleij S, van Erpecum KJ. Long-term exclusive zinc monotherapyin symptomatic Wilson disease: Experience in 17 patients #. Hepatology. 2009;50(5):1442\u201352. https:\/\/doi.org\/10.1002\/hep.23182","DOI":"10.1002\/hep.23182"},{"key":"6273_CR16","doi-asserted-by":"publisher","unstructured":"Kodama H, Anan Y, Izumi Y, Sato Y, Ogra Y. Copper and zinc concentrations in the breast milk of mother sundergoing treatment for Wilson\u2019s disease: A prospective study. BMJ Paediatr Open. 2021;5(1). https:\/\/doi.org\/10.1136\/bmjpo-2020-000948","DOI":"10.1136\/bmjpo-2020-000948"},{"key":"6273_CR17","unstructured":"UN Office for the Coordination of Humanitarian Affairs. Humanitarian needs and response plan Myanmar 2024 [Internet]. 2023 [cited 2024 Oct 17]. 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J Glob Health. 2023. https:\/\/doi.org\/10.7189\/jogh.13.03002.","journal-title":"J Glob Health"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-026-06273-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-026-06273-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-026-06273-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:04:50Z","timestamp":1785513890000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13256-026-06273-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6273"],"URL":"https:\/\/doi.org\/10.1186\/s13256-026-06273-8","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"23 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The patient gave written informed consent to participate in the case report. Ethical approval for retrospective analysis of hospital archives at the Shoklo Malaria Research Unit (SMRU) was provided by the Oxford University Ethics Committee (OXTREC: 28-09), and the local community advisory board in Mae-Sot, Thailand (TCAB-4\/1\/2015).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interest.","order":3,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"434"}}