title: Fulminant Wilson's Disease Managed with Plasmapheresis as a Bridge to Liver Transplant.
abstract: New-onset jaundice can be a manifestation of multiple pathologic processes including hemolysis, parenchymal liver disease, and cholestasis; the differential diagnosis is broad and requires a systematic approach. We report a case of a patient who presented with jaundice after starting minocycline for the treatment of acne vulgaris and rapidly developed fulminant liver failure found to be due to Wilson's disease. She also manifested severe Coomb's negative hemolytic anemia and renal failure secondary to hepatorenal syndrome. As a bridge to liver transplant, she was successfully treated with plasmapheresis to decrease serum copper in addition to hemodialysis for acidosis and hyperkalemia. She was able to receive a liver and made a full recovery. The case highlights the use of plasmapheresis as an adjunctive treatment modality in cases of fulminant liver failure due to Wilson's disease.
authors.affiliation: Department of Internal Medicine, University of Kentucky College of Medicine, Charles T. Wethington Building 304B, 900 South Limestone Street, Lexington, KY 40536, USA.
authors.forename: Talal
authors.identifier: 0000-0001-8249-4128
authors.initials: T
authors.lastname: Hilal
authors.affiliation: Department of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky College of Medicine, Kentucky Clinic L543, 740 South Limestone Street, Lexington, KY 40536, USA.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Morehead