Editing Wilson's disease (section)

===Liver disease===
Liver disease may present itself as [[tiredness]], [[jaundice]], increased bleeding tendency or confusion (due to [[hepatic encephalopathy]]), and [[portal hypertension]].<ref>{{Cite web |title=Wilson's disease - Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/wilsons-disease/symptoms-causes/syc-20353251 |access-date=2022-10-05 |website=Mayo Clinic |language=en}}</ref> The last, a condition in which the pressure in the [[portal vein]] is markedly increased, leads to [[esophageal varices]] (distended veins in the [[esophagus]] that may bleed in a life-threatening fashion) as well as enlargement of the spleen ([[splenomegaly]]) and accumulation of fluid in the abdominal cavity ([[ascites]]). On examination, signs of chronic liver disease such as [[spider angioma]]ta (small distended blood vessels, usually on the chest) may be observed. [[Chronic active hepatitis]] has already caused [[cirrhosis]] of the liver in most patients by the time they develop symptoms. While most people with cirrhosis have an increased risk of [[hepatocellular carcinoma]] (liver cancer), this risk is relatively low in Wilson's disease.<ref name=Ala/>

About 5% of all people are diagnosed only when they develop [[fulminant]] [[acute liver failure]], often in the context of [[hemolytic anemia]] (anemia due to the destruction of red blood cells). This leads to abnormalities in protein production (identified by [[Coagulopathy|deranged coagulation]]) and metabolism by the liver. The deranged protein metabolism leads to the accumulation of waste products, such as [[ammonia]], in the bloodstream. When these irritate the brain, patients develop [[hepatic encephalopathy]] – a serious condition that causes confusion, coma, seizures and, finally, life-threatening [[Cerebral edema|swelling of the brain]]).<ref name=Ala/>