**Question:** Wilson’s disease is characterised by all except?

A. Hepatic symptoms
B. Extrapulmonary manifestations
C. Psychiatric symptoms
D. Hepatitis

**Core Concept:** Wilson's disease is a rare autosomal recessive disorder caused by mutations in the ATP7B gene, leading to copper accumulation in the liver, brain, and other tissues. This results in various clinical manifestations.

**Why the Correct Answer is Right:** Wilson's disease primarily affects the liver, causing symptoms like elevated liver enzymes and coagulopathy. Extrapulmonary manifestations are not specific to Wilson's disease, making option D incorrect. Hepatitis usually refers to acute liver inflammation, which is not the main feature of Wilson's disease.

**Why Each Wrong Option is Incorrect:**

A. Hepatic symptoms: While Wilson's disease can present with liver dysfunction, the correct answer does not include all hepatic symptoms.
B. Extrapulmonary manifestations: Although Wilson's disease can affect various organs, the correct answer does not encompass all extrahepatic manifestations.
C. Psychiatric symptoms: Wilson's disease can present with psychiatric manifestations like depression, anxiety, and psychosis; however, the correct answer does not include all psychiatric symptoms.

**Clinical Pearl:** Wilson's disease typically presents with a triad of Kayser-Fleischer rings (brown discoloration in the conjunctiva), copper-induced liver disease, and psychiatric symptoms. Extrapulmonary and hepatic manifestations are not present in all cases, making option D the correct answer.

**Correct Answer:** D. Hepatitis