{
  "abstract": "Wilson disease is a rare inherited disorder of copper metabolism that can cause progressive hepatic injury, cirrhosis, and, in severe cases, acute liver failure. Its variable presentation can overlap with more common causes of liver disease and delay recognition. We present a 28-year-old patient with one week of worsening jaundice, right upper quadrant abdominal pain, nausea and vomiting, and marked hyperbilirubinemia. Given a history of heavy alcohol use and a Maddrey Discriminant Function score of 73, severe alcohol-associated hepatitis was initially suspected. However, several months of reported alcohol abstinence, a strong maternal family history of early-onset cirrhosis, imaging evidence of established portal hypertension, and the severity of hepatic dysfunction prompted broader evaluation. Testing demonstrated low ceruloplasmin and elevated 24-h urinary copper, while autoimmune and viral testing was unrevealing. The overall clinical evaluation favored Wilson disease. During the hospitalization, suspected hepatorenal syndrome was managed with albumin, midodrine, and octreotide; portal-hypertensive ascites required paracentesis; and trientine plus zinc were prescribed as disease-specific therapy while transplant evaluation was pursued. Renal function improved, but severe liver disease persisted, and the patient was transferred to a transplant center for further evaluation. Long-term follow-up after transfer was unavailable. This case highlights the need to maintain a broad differential diagnosis in young adults with acute decompensation of chronic liver disease and to distinguish clinical diagnostic confidence from the degree of objective Wilson disease confirmation achieved during the index hospitalization.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, The University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, United States.",
    "Department of Internal Medicine, The University of Texas Health Science Center at San Antonio Joe R and Teresa Lozano Long School of Medicine, San Antonio, TX, United States.",
    "Valley Baptist Medical Center - Department of Internal Medicine, The University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, United States."
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Aun Ali Bangash"
    },
    {
      "affs": [
        1
      ],
      "name": "Muhammad Ali Bangash"
    },
    {
      "affs": [
        0
      ],
      "name": "Chloe Cheree Harris"
    },
    {
      "affs": [
        0
      ],
      "name": "Veronica O'Brien"
    },
    {
      "affs": [
        0
      ],
      "name": "Learsi De Hoyos"
    },
    {
      "affs": [
        2
      ],
      "name": "Jose Campo Maldonado"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/65crap4pqz4pp.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1973024",
  "fulltext_url": "https://europepmc.org/articles/PMC13714812",
  "id": "65crap4pqz4pp",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42953602",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2916|Trace Elements in Health"
    ]
  ],
  "openalex": "W7221771228",
  "pdf_url": "https://europepmc.org/articles/PMC13714812?pdf=render",
  "pmcid": "PMC13714812",
  "pmid": "42953602",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/65crap4pqz4pp.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:41Z",
      "native_id": "MED:42953602",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42953602"
    },
    {
      "first_seen": "2026-11-01T12:22:14Z",
      "native_id": "PMC13714812",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1973024"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Case Report: Beyond the initial diagnosis: a case of Wilson's disease presenting as acute decompensated cirrhosis.",
  "title_text": "Case Report: Beyond the initial diagnosis: a case of Wilson's disease presenting as acute decompensated cirrhosis.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:14Z",
  "url": "https://research.draconitic.com/paper/65crap4pqz4pp",
  "venue": "Frontiers in medicine",
  "versions": []
}