Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2019; 11(7): 607-612
Published online Jul 27, 2019. doi: 10.4254/wjh.v11.i7.607
Wilson disease developing osteoarthritic pain in severe acute liver failure: A case report
Jun Kido, Shirou Matsumoto, Keishin Sugawara, Kimitoshi Nakamura
Jun Kido, Shirou Matsumoto, Keishin Sugawara, Kimitoshi Nakamura, Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
Author contributions: Kido J and Nakamura K designed the report; Kido J, Matsumoto S and Sugawara K collected the patient’s clinical data; Kido J and Matsumoto S analyzed the data; Kido J wrote the paper; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from this patient and his parents.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jun Kido, MD, PhD, Assistant Professor, Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. kidojun@kuh.kumamoto-u.ac.jp
Telephone: +81-96-3735191 Fax: +81-96-3735335
Received: March 20, 2019
Peer-review started: March 20, 2019
First decision: April 23, 2019
Revised: May 20, 2019
Accepted: June 27, 2019
Article in press: June 27, 2019
Published online: July 27, 2019
Processing time: 129 Days and 3.8 Hours
Core Tip

Core tip: We present an 11-year-old boy with Wilson disease (WD) who developed osteoarthritis symptoms and acute liver failure, with a New Wilson Index Score (NWIS) of 12. His liver cirrhosis improved, leading to almost normal liver function and liver imaging results, one year after receiving combination therapy with Zn and a chelator. Patients with WD with a NWIS > 11 may be able to survive with treatment with Zn and chelators, without liver transplantation, in cases wherein they present with mild hyperbilirubinemia and stage ≤ II hepatic encephalopathy. Symptoms of associated osteoarthritis may also improve with long-term Zn and chelator therapy.