A Case of Fulminant Wilson's Disease Complicated with Citrate Toxicity

Abstract

When Wilson's disease is accompanied with severe acute liver failure, it is named as fulminant Wilson's disease, which is a life-threatening condition. With the widespread use of rapid diagnostic facilities and therapeutic plasma exchange in preparation of transplantation as well as the correct use of similar bridge treatments, mortality rate can be lowered. A 14-year-old female patient presented with hemolytic anemia. Based on the preliminary diagnosis, her indirect hyperbilirubinemia was treated with plasmapheresis until she was definitely diagnosed with Wilson's disease; she soon died due to severe hemorrhagic complications. We are presenting our case to highlight that bridge therapies may be unsuccessful because of rapidly developing clinical manifestations despite plasmapheresis; and as well to remind, transfusions may cause citrate toxicity as in this patient.