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Case Reports in Medicine
Volume 2014 (2014), Article ID 672985, 4 pages
Case Report

Fulminant Wilson’s Disease Managed with Plasmapheresis as a Bridge to Liver Transplant

1Department of Internal Medicine, University of Kentucky College of Medicine, Charles T. Wethington Building 304B, 900 South Limestone Street, Lexington, KY 40536, USA
2Department of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky College of Medicine, Kentucky Clinic L543, 740 South Limestone Street, Lexington, KY 40536, USA

Received 15 July 2014; Revised 29 August 2014; Accepted 29 August 2014; Published 9 September 2014

Academic Editor: Piotr K. Janicki

Copyright © 2014 Talal Hilal and R. Scott Morehead. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.