# Fatal Crossroads: D-penicillamine and Disseminated Intravascular Coagulation in Wilson’s Disease

**Authors:** Razan Mando, Hamza Haj Mohamad, Mariam Abdelkader, Amna Alketbi, Mohammed Alzebari, Dhuha Ali Eledresi, Ubaid Hashmi, Mahasin Shaheen

PMC · DOI: 10.7759/cureus.80726 · Cureus · 2025-03-17

## TL;DR

A teenager with Wilson’s disease developed severe blood clotting issues after treatment with D-penicillamine, highlighting a dangerous side effect.

## Contribution

This case report highlights a rare but severe risk of DIC associated with D-penicillamine in Wilson’s disease patients.

## Key findings

- A 13-year-old with Wilson’s disease developed DIC after D-penicillamine treatment.
- DIC rapidly progressed despite aggressive management, leading to severe complications.
- The case emphasizes the need for caution and alternative therapies in susceptible patients.

## Abstract

A 13-year-old male with Wilson’s disease presented with progressive edema, jaundice, and neuropsychiatric symptoms. His evaluation revealed advanced hepatic dysfunction (Child-Pugh Class C), confirmed by biochemical, imaging, and histopathological findings. Despite initial stabilization, he was readmitted with acute gastrointestinal bleeding, hypotension, and laboratory evidence of disseminated intravascular coagulation (DIC), which rapidly progressed despite aggressive management. This case underscores the potential risk of DIC with D-penicillamine in Wilson’s disease and highlights the need for vigilance, early recognition, and consideration of alternative treatments in susceptible patients.

## Linked entities

- **Chemicals:** D-penicillamine (PubChem CID 5852)
- **Diseases:** Wilson’s disease (MONDO:0010200), disseminated intravascular coagulation (MONDO:0001243)

## Full-text entities

- **Diseases:** Wilson's Disease (MESH:D006527), jaundice (MESH:D007565), DIC (MESH:D004211), neuropsychiatric symptoms (MESH:D001523), edema (MESH:D004487), hepatic dysfunction (MESH:D008107), Child-Pugh (MESH:C562515), gastrointestinal bleeding (MESH:D006471), hypotension (MESH:D007022)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12001300/full.md

## References

5 references — full list in the complete paper: https://tomesphere.com/paper/PMC12001300/full.md

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Source: https://tomesphere.com/paper/PMC12001300