Abstract
We experienced a 25-years-old fulminant hepatitis patient who could be diagnosed as Wilson's disease. The patient was originally healthy and admitted due to jaundice. She was diagnosed as unknown etiology fulminant hepatitis. Despite plasma exchange therapy, her hepatic coma and data did not improve and she received living related liver transplantation from her father. Her liver was liver cirrhosis with hepatocyte necrosis and cell infiltration and positive for copper staining. From copper-related marker, she was diagnosed as Wilson's disease. As far as we investigated, 25-years-old is highest age among fulminant Wilson's disease cases in Japan. Although it was difficult to diagnose Wilson's disease in cases without Kayser-Fleischer ring and neurological abnormality, Wilson's disease should be considered as an etiology of unknown fulminant hepatitis even adult cases and the ratios of ALP/T-Bil and AST/ALT and urinary copper were useful for the diagnosis of fulmiant Wilson's diseases.
