DOC in Wilson disease with Neurologic/Psychiatric manifestation is:
**Core Concept**
Wilson disease is a genetic disorder characterized by excessive accumulation of copper in the body, particularly in the liver, brain, and other organs. The neurological and psychiatric manifestations are a result of copper deposition in the brain, leading to damage of the basal ganglia and other structures. Effective treatment requires a chelating agent that can safely remove excess copper from the body.
**Why the Correct Answer is Right**
Penicillamine is a chelating agent that is specifically used to treat Wilson disease with neurological and psychiatric manifestations. It works by forming a stable complex with copper, allowing it to be excreted in the urine. Penicillamine is particularly effective in this context because it has a high affinity for copper and can safely remove it from the body without causing significant harm. The use of penicillamine in Wilson disease is well-established and is considered a first-line treatment option for patients with neurological and psychiatric symptoms.
**Why Each Wrong Option is Incorrect**
**Option A:** Zinc acetate is used as a maintenance therapy to prevent copper accumulation in Wilson disease, but it is not the drug of choice for acute treatment of neurological and psychiatric manifestations.
**Option B:** Trientine is another chelating agent used to treat Wilson disease, but it is more commonly used in patients who are allergic to penicillamine or have a history of penicillamine-induced lupus.
**Option C:** Deferoxamine is a chelating agent used to treat iron overload, not copper accumulation in Wilson disease.
**Clinical Pearl / High-Yield Fact**
Remember that penicillamine is a specific treatment for Wilson disease with neurological and psychiatric manifestations, but it requires careful monitoring to prevent side effects such as nephrotic syndrome and agranulocytosis.
**Correct Answer:** C. Penicillamine