Treatment of Wilson's Disease During Pregnancy or Breastfeeding

Women with Wilson's disease who become pregnant or are breastfeeding present a distinct clinical challenge: anti-copper therapy must be balanced against the safety of both mother and child. Stopping treatment is not considered safe.

Clinical scenario

Female patient with Wilson's disease who is currently pregnant or breastfeeding. Maintaining copper control throughout this period is essential; untreated maternal Wilson's disease poses serious risks regardless of the stage of pregnancy or lactation.

Treatment approach (partial)

Anti-copper therapy is continued throughout pregnancy and breastfeeding, with the specific choice of agent and extent of treatment adjusted according to the clinical context.

Complete regimen details, agent selection, dose guidance, and trimester-specific considerations are in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jhep.2024.11.007

Any anti-copper therapy should be maintained during pregnancy and breastfeeding (LoE 4, weak recommendation, consensus).
The speculative risk of over chelation affecting foetal outcomes has led to the conservative recommendation to reduce the dose of copper-chelating agents during the first trimester.
Zinc is usually considered safe in pregnancy, although birth defects in zinc-treated women have been reported.

View source ↗