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Fulminant hepatic failure with virtually undetectable serum alkaline phosphatase
Clinical Laboratory
|April 5, 2014
Summary
Fulminant hepatic failure as an initial symptom of Wilson's disease is rare but serious. Low alkaline phosphatase levels can be a key diagnostic clue for this condition.
Area of Science:
- Hepatology
- Genetic metabolic disorders
- Clinical diagnostics
Background:
- Wilson's disease is a rare autosomal recessive genetic disorder of copper metabolism.
- Fulminant hepatic failure (FHF) is an uncommon but severe presentation of Wilson's disease.
- High morbidity and mortality are associated with Wilson's disease presenting as FHF.
Observation:
- A young patient presented with FHF as the initial manifestation of Wilson's disease.
- Serum alkaline phosphatase levels were virtually undetectable in the patient.
- This unusual laboratory finding served as an early indicator for the diagnosis.
Findings:
- The case highlights the diagnostic utility of extremely low serum alkaline phosphatase in suspecting Wilson's disease.
- Liver transplantation was successfully performed, representing the definitive treatment for Wilsonian FHF.
- Discussion of laboratory clues aids in identifying this rare presentation.
Implications:
- Clinicians must maintain a high index of suspicion for Wilson's disease in cases of unexplained FHF.
- Early diagnosis and intervention are critical to prevent catastrophic outcomes.
- Understanding subtle laboratory findings can significantly improve patient management in Wilson's disease.
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