Journal of Liver

Abstract

Detection of Undiagnosed Wilson's Disease after Hepatitis A Virus Infection

Reza Dabiri, Ali Bastani and Amir Houshang Mohammad Alizadeh

Introduction: Some reports have considered hepatitis A as a possible factor in the development of acute decompensation in patients with Wilson’s disease. Here we report the case of a delayed diagnosis of Wilson’s disease in the end of the third decade of life in a patient infected with hepatitis A. Case report: The patient was a 26 year old woman with complaints of nausea and vomiting, anorexia, ichter, fever and epigastric pain since a week before admission. She had not any history of previous disease in herself and her families. Considering an increase in liver enzymes, serum bilirubin levels, serum IgM HAV antibody positivity and symptoms suggestive of hepatitis A associated with autoimmune hepatitis considered and patient was treated and then discharged. The patient returned two weeks later and symptoms such as ichter, fatigue and edema of the lower extremities were still present. Wilson’s disease is suspected, laboratory testing and ophthalmologic examination was performed and diagnosis was confirmed. The patient was treated with D-penicillamin, pyridoxine, and zinc sulfate. On reexamination, the patient’s symptoms largely resolved and in the following experiments response to treatment was appropriate. Conclusion: Hepatitis A can be considered as a factor for acute decompensation in undiagnosed patients with Wilson’s disease.