# Hemolytic Anemia Leading to Fulminant Hepatic Failure as the Initial Presentation of Wilson’s Disease in a Young Female

## TL;DR

A young woman with Wilson’s disease showed rare initial symptoms of hemolytic anemia and severe liver failure, highlighting the need for early diagnosis.

## Contribution

This case highlights a rare initial presentation of Wilson’s disease with hemolytic anemia and fulminant hepatic failure.

## Key findings

- Hemolytic anemia can be an initial sign of Wilson’s disease.
- Fulminant hepatic failure may rapidly develop in undiagnosed Wilson’s disease.
- Early diagnosis and treatment are crucial for survival in Wilson’s disease.

## Abstract

Wilson’s disease (WD) is an autosomal recessive disorder that impairs copper metabolism. Copper accumulates in vital organs such as the brain, liver, and kidneys. The disease typically starts with copper accumulation in the liver and can initially present as acute hepatitis and hepatomegaly. Hemolytic anemia is a typically uncommon complication of WD. We present the case of a healthy 18-year-old female who presented with hemolytic anemia and quickly decompensated to fulminant hepatic failure requiring a liver transplant due to previously undiagnosed WD. This case recognizes the importance of early diagnosis as treatment can be lifesaving.