Year 2003 / Volume 95 / Number 1
Notas
D-penicillamine and plasmapheresis in acute liver failure

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E. Rodríguez Fariña, G. Tremosa Llurba, X. Xiol Quingles, A. Lores Obradors, J. Castellote Alonso, J. B. Gornals Soler y C. López Núñez

Abstract
We report a case of a 19-year-old woman with acute liver failure, Coombs´ negative hemolytic anemia, and renal failure as initial manifestations of Wilson´s disease with recovery following
medical treatment. The clinical picture and low serum transaminase and alkaline phosphatase levels gave us a clue to suspect Wilson ´s disease and to initiate plasmapheresis and D-penicillamine soon after admission. The serum and urinary copper levels were elevated with low serum ceruloplasmin. We proceeded to ambulatory
follow-up with medical treatment with D-penicillamine. A few months later, during the course of a laparoscopic cholecystectomy
because of symptomatic gallstone disease, a liver biopsy sample was obtained that showed histological liver fibrosis and strongly
elevated levels of liver tissue copper.
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E. Rodríguez Fariña, G. Tremosa Llurba, X. Xiol Quingles, A. Lores Obradors, J. Castellote Alonso, J. B. Gornals Soler y C. López Núñez. D-penicillamine and plasmapheresis in acute liver failure. 0


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