Publication Name	World Journal of Clinical Cases
Manuscript ID	59730
Country	Germany

Received	2020-09-24 15:56
Peer-Review Started	2020-09-24 15:57
To Make the First Decision
Return for Revision	2020-12-08 08:16
Revised	2020-12-08 09:05
Second Decision	2020-12-17 12:25
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2020-12-23 05:01
Articles in Press	2020-12-23 05:01
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript	2021-01-21 02:06
Publish the Manuscript Online	2021-02-06 11:08

ISSN	2307-8960 (online)
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Category	Gastroenterology & Hepatology
Manuscript Type	Case Report
Article Title	Wilson disease — the impact of hyperimmunity on disease activity: A case report
Manuscript Source	Unsolicited Manuscript
All Author List	Wolfgang Stremmel, Thomas Longerich, René Liere, Vladimir Vacata, Josef van Helden and Ralf Weiskirchen
Funding Agency and Grant Number
Corresponding Author	Wolfgang Stremmel, MD, Senior Scientist, Department of Gastroenterology and Hepatology, Medical Center Baden-Baden, Im Neuenheimer Feld 410, Baden-Baden D-76530, Germany. wolfgangstremmel@aol.com
Key Words	Wilson disease; Copper metabolism; Antinuclear antibodies; Diagnosis; Steroid therapy; Case report
Core Tip	Variable courses of metabolic liver diseases remain obscure. A 9-year-old girl with Wilson disease had concomitant antinuclear antibodies elevation without immunoglobulin G elevation. Already after one year of therapy with copper chelators the free copper as treatment target was normalized as well as transaminases. Six years later transaminases (alanine aminotransferase) rose despite normalized free copper up to 571 U/L in December 2019. A short-term steroid therapy, improved transaminases significantly. As underlying course, such a neglected hyperimmune state without immunoglobulin elevation was verified in a cohort of 5.789 liver disease patients and may represent a new entity explaining liver disease activation.
Publish Date	2021-02-06 11:08
Citation	Stremmel W, Longerich T, Liere R, Vacata V, van Helden J, Weiskirchen R. Wilson disease — the impact of hyperimmunity on disease activity: A case report. World J Clin Cases 2021; 9(6): 1386-1393
URL	https://www.wjgnet.com/2307-8960/full/v9/i6/1386.htm
DOI	https://dx.doi.org/10.12998/wjcc.v9.i6.1386

Full Article (PDF)	WJCC-9-1386.pdf
Full Article (Word)	WJCC-9-1386.docx
Manuscript File	59730_Auto_Edited.docx
Answering Reviewers	59730-Answering reviewers.pdf
Audio Core Tip	59730-Audio core tip.m4a
Conflict-of-Interest Disclosure Form	59730-Conflict-of-interest statement.pdf
Copyright License Agreement	59730-Copyright license agreement.pdf
Signed Informed Consent Form(s) or Document(s)	59730-Informed consent statement.pdf
Peer-review Report	59730-Peer-review(s).pdf
Scientific Misconduct Check	59730-Bing-Yan JP-1.png
Scientific Misconduct Check	59730-Scientific misconduct check.pdf
Scientific Editor Work List	59730-Scientific editor work list.pdf