A 15-year-old girl with severe hemolytic Wilson's crisis recovered without transplantation after extracorporeal circulation with the Prometheus system.

Abstract:

BACKGROUND:Wilson's disease (WD) can present in a fulminant form with hepatocellular dysfunction, hemolysis and multiorgan failure (Wilson's crisis). We present a previously healthy young woman with severe WD whose WD severity score was 13. A score >11 indicates a poor chance of survival and liver transplantation will usually be recommended. METHODS:Penicillamine and acetylcysteine were initially administered, but the patient deteriorated further, and extracorporeal liver support with the Prometheus FPSA (fractionated plasma separation and adsorption) system was initiated. The patient was treated 6 h daily during 3 consecutive days. RESULTS:Severe hemolysis was reduced to low-grade hemolysis, with no further need for transfusions. The mental state improved and after 4 months practically all biochemical markers were normalized. CONCLUSIONS:This is the first report of FPSA albumin dialysis of a patient with Wilson's crisis and the first report in which a patient with a WD score >11 survived without transplantation.

journal_name

Blood Purif

journal_title

Blood purification

authors

Aagaard NK,Thomsen KL,Holland-Fischer P,Jørgensen SP,Ott P

doi

10.1159/000218090

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

102-7

issue

2

eissn

0253-5068

issn

1421-9735

pii

000218090

journal_volume

28

pub_type

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