Fulminant hepatic failure during perinatal period in a pregnant woman with Wilson's disease

Nobuyuki Shimono, Hiromi Ishibashi, Hideyuki Ikematsu, Jiro Kudo, Masafumi Shirahama, Shouichi Inaba, Kazunobu Maeda, Kazuo Yamasaki, Yoshiyuki Niho

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Abstract

Wilson's disease associated with hepatic failure is not common and the underlying mechanism triggering the event is not known at present. We treated a 28-year-old Japanese woman with Wilson's disease who developed hepatic failure associated with hemolytic crisis just after delivery. She was diagnosed as having Wilson's disease at 12 years of age, at which time she started taking D-penicillamine. She had previously delivered two children without difficulty. When she found out she was pregnant this time, she stopped taking D-penicillamine in contrast to taking it faithfully during her first two pregnancies. On the day of delivery of her full-term baby, jaundice developed accompanied with severe hemolytic crisis. Plasma exchanges and blood transfusion were performed and D-penicillamine administration was started again. She gradually recovered and apparently was following a good clinical course. However, on day 30 the second hemolytic crisis occurred and subsequent liver failure led her to death on day 50. At autopsy her liver was cirrhotic and showed massive necrosis. Prophylactic oral administration of D-penicillamine and careful observation are therefore recommended to prevent hemolytic crisis during the perinatal period.

Original languageEnglish
Pages (from-to)69-73
Number of pages5
JournalGastroenterologia Japonica
Volume26
Issue number1
DOIs
Publication statusPublished - Feb 1 1991

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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    Shimono, N., Ishibashi, H., Ikematsu, H., Kudo, J., Shirahama, M., Inaba, S., Maeda, K., Yamasaki, K., & Niho, Y. (1991). Fulminant hepatic failure during perinatal period in a pregnant woman with Wilson's disease. Gastroenterologia Japonica, 26(1), 69-73. https://doi.org/10.1007/BF02779512