title: [Hemolytic anemia as the first clinical presentation of Wilson disease: a pediatric case].
abstract: Wilson disease is an autosomal recessive disorder of the copper's hepatic metabolism; it results in toxicity due to accumulation of the mineral. The hemolytic anemia is present in 17% at some point of the disease, although it is a rare initial clinical presentation.
  
  
  METHODS
  11 years old boy who presented with negative Coombs hemolytic anemia and elevation of liver enzymes. The possibility of Wilson disease was considered, which was confirmed with the finding of a Kayser-Fleischer ring in the eye exam. He also had a low ceruloplasmin level in plasma and a high urinary copper excretion. He was treated with D-penicillamine and pyridoxine.
authors.affiliation: Universidad Escuela Autónoma de Ciencias Médicas de Centroamérica, San José, Costa Rica.
authors.forename: José A
authors.initials: JA
authors.lastname: Henao C
authors.affiliation: Servicio de Hematología, Hospital Nacional de Niños, San José, Costa Rica. kathyvalverdem@gmail.com.
authors.forename: Kathia
authors.initials: K
authors.lastname: Valverde Muñoz
authors.affiliation: Servicio de Infectología, Hospital Nacional de Niños, San José, Costa Rica.
authors.forename: María L
authors.initials: ML
authors.lastname: Ávila A
mesh_terms: D000743:Anemia, Hemolytic / Q000209:etiology; D002648:Child; D006527:Hepatolenticular Degeneration / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male
keywords: Coombs test; Hemolytic anemia; Wilson disease