A 34-year-old woman with Wilson disease presents with acute liver failure, hemolytic anemia, and tremor. Vital signs show BP 92/58, HR 118, RR 22, temperature 37.2°C, SpO2 98% on room air. Laboratory studies reveal undetectable serum ceruloplasmin, massively elevated urinary copper excretion, INR 4.2, and hemoglobin 7.8 g/dL. She denies abdominal pain. The patient is neurologically unstable. Which of the following is the most appropriate urgent intervention?
- A)Supportive care with corticosteroids
- B)Penicillamine initiation with zinc supplementation
- C)Urgent liver transplantationGABARITO
- D)Plasmapheresis for copper removal
- E)Chelation therapy with deferasirox
Explicação
Acute fulminant hepatic failure from Wilson disease with neurological involvement is an absolute indication for urgent liver transplantation. Medical therapy cannot rapidly reverse copper toxicity in this setting, and transplantation is curative. Ver explicação completa e trilha adaptativa →