Leipzig Score (Wilson Disease diagnosis)

Scores the Leipzig (Ferenci) system for diagnosing Wilson disease.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Kayser-Fleischer rings
Present
Neurologic symptoms or MRI changes
Severe
Serum ceruloplasmin
Below 0.1 g/L
Quantitative liver copper
Not available
24-hour urinary copper
Normal
ATP7B mutation analysis
No disease-causing variant found
Coombs-negative hemolytic anemia
Absent

Result: Leipzig score 6

The tool opens with these values already filled in. Replace them with your own.

What the result means

4 or more
Diagnosis of Wilson disease established.
Exactly 3
Diagnosis possible; more tests needed.
2 or fewer
Diagnosis very unlikely.
Mutation
Deleterious ATP7B variants on both chromosomes score 4 - enough on their own to establish the diagnosis. One chromosome scores 1.
Minus one
A NORMAL quantitative liver copper scores MINUS 1, not zero. It is evidence against the diagnosis, so an add-only reading of the table overstates the total.
Rhodanine
Rhodanine-positive granules score 1 only when no quantitative liver copper is available. They stand in for it; counting both double-counts the same histology.

What you enter

  • Kayser-Fleischer rings
  • Neurologic symptoms or MRI changes
  • Serum ceruloplasmin
  • Coombs-negative hemolytic anemia
  • Quantitative liver copper
  • Rhodanine-positive granules
  • 24-hour urinary copper
  • ATP7B mutation analysis
How this is calculated
Weights
KF rings 2. Neurologic severe 2, mild 1. Ceruloplasmin 0.1-0.2 g/L 1, below 0.1 2. Coombs-negative hemolysis 1. Urinary copper 1-2x ULN 1, above 2x 2, or 2 if above 5x after D-penicillamine.

Ferenci P, Caca K, Loudianos G, et al. Diagnosis and phenotypic classification of Wilson disease. Liver Int. 2003;23(3):139-142. Agreed by the Working Party at the 8th International Meeting on Wilson Disease, Leipzig 2001. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.