Wilson's disease followed by liver transplant in a 20-year-old female: considerations for bone health--case report and review of the literature.
Osteopenia and osteoporosis have a high prevalence in patients with chronic liver disease and post transplantation. We report the case of a 20-year-old female who underwent urgent liver transplant after presenting with fulminant hepatic failure secondary to Wilson's Disease. She was seen in consultation in the Osteoporosis Clinic eight months after liver transplantation with low bone-mineral density. Risks for osteoporosis in patients with chronic liver disease include hypogonadism, vitamin D deficiency and medications, and fracture rates are twice those of age-matched controls. In patients who undergo liver transplant, bone loss is more pronounced in the first year post-transplant, consistent with aggressive medical therapy, immobilization and hypogonadism secondary to immunosupressants. Wilson's disease is also known to cause bone loss independent of liver dysfunction. Evaluation of patients with Wilson's disease who have undergone transplantation is indicated for the prevention and treatment of bone loss.
Boldo
Angela
A
University of Connecticut Health Center, Medicine Department, Farmington, USA.
Taxel
Pamela
P
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006527:Hepatolenticular Degeneration / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus