Clinically diagnosed late-onset fulminant Wilson’s disease without cirrhosis: A case report

Figure 1 Contrast computerized tomography before the treatment. A: CT revealed hepatomegaly with no mass or dilatation of the intrahepatic duct in the liver; B: CT revealed splenomegaly. CT: Computerized tomography.

Figure 2 Bone marrow examination revealed macrophages phagocytizing blood cells.

Figure 3 Time courses of laboratory data and treatment. ALT (U/L): Alanine aminotransferase; AST (U/L): Aspartate aminotransferase; CHDF: Continuous hemodiafiltration; FFP: Fresh frozen plasma; Hb (g/dL): Hemoglobin; mPSL: Methylprednisolone; NH₃ (μg/dL): Ammonia; PT (%): Prothrombin time; Plt (×10⁴/μL): Platelet; RBC: Red blood cell; T-Bil (mg/dL): Total bilirubin; UDCA: Ursodeoxycholic acid.

Figure 4 Pathological findings in the liver. A: The liver (1580 g) was bile stained and soft; B: Low power field: The capsule was wrinkled in HE staining; C: High power field: Microscopically, the liver showed massive necrosis and collapse of the intervening parenchyma in HE staining; D: Low power field in AZAN staining; E: High power field in AZAN staining: Bridging pattern of fibrosis suggestive of chronic liver injury was not found. HE: Hematoxylin-eosin.