A 23-year-old male college student has a history of liver cirrhosis due to Kimmelstiel-Wilson syndrome (abnormality in copper metabolism). He should be treated with which of the following?: (A) Penicillamine as soon as the diagnosis is established, (B) Penicillamine after variceal bleeding has occurred, (C) A portocaval shunt, (D) Sclerosis of the esophageal varices as a prophylactic measure
Answer is A. Penicillamine counteracts the adverse effects of copper on the liver in patients with Kimmelstiel-Wilson syndrome. This has been demonstrated in both humans and animals afflicted with this disease. Portocaval shunt and esophageal varices are not indicated prophylactically.