Calculators & Tools

Leipzig Score (Wilson Disease)

Diagnostic scoring system for Wilson disease.

1 What is the Leipzig Score (Wilson Disease)?

The Leipzig Score (Wilson Disease) is a GI & Liver scoring tool used in paediatric practice. Diagnostic scoring system for Wilson disease. It scores 8 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in GI & Liver
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 8 criteria: Kayser-Fleischer rings; Neurological symptoms or typical MRI brain changes; Serum caeruloplasmin; Coombs-negative haemolytic anaemia; Liver copper (in the absence of cholestasis); Rhodanine-positive granules (if copper unavailable); Urinary copper (in the absence of acute hepatitis); ATP7B mutation analysis. Totals are then banded: -1 points or more - Unlikely: score 0-1 - Wilson disease unlikely. Consider alternative causes of liver disease; 2 points or more - Possible: score 2-3 - possible Wilson disease; more investigations needed (24-h urinary copper, penicillamine challenge, liver biopsy, ATP7B sequencing); 4 points or more - Highly likely: score ≥4 - diagnosis of Wilson disease established. Start chelation/zinc therapy, screen siblings, and refer to hepatology.
  • Agreed at the 8th International Meeting on Wilson Disease, Leipzig 2001.
  • Source: Ferenci P et al. Diagnosis and phenotypic classification of Wilson disease. Liver Int 2003;23:139-42.

4 Frequently asked questions

How many criteria does the Leipzig Score (Wilson Disease) use?

8. They are Kayser-Fleischer rings; Neurological symptoms or typical MRI brain changes; Serum caeruloplasmin; Coombs-negative haemolytic anaemia; Liver copper (in the absence of cholestasis); Rhodanine-positive granules (if copper unavailable); and others.

What do the bands of the Leipzig Score (Wilson Disease) mean?

The total is interpreted as: -1 points or more - Unlikely: score 0-1 - Wilson disease unlikely. Consider alternative causes of liver disease; 2 points or more - Possible: score 2-3 - possible Wilson disease; more investigations needed (24-h urinary copper, penicillamine challenge, liver biopsy, ATP7B sequencing); 4 points or more - Highly likely: score ≥4 - diagnosis of Wilson disease established. Start chelation/zinc therapy, screen siblings, and refer to hepatology.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Agreed at the 8th International Meeting on Wilson Disease, Leipzig 2001.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.