Therapeutic Plasma Exchange in a Patient with Fulminant Wilson's Disease

Patient selection: fulminant hepatic failure due to Wilson's disease

Concurrent conditions may include:

(1) renal failure

(2) hemolytic anemia

(3) encephalopathy and/or neuropsychiatric symptoms

Management may include:

(1) therapeutic plasma exchange, typically daily or every other day, with FFP or albumin replacement

(2) chelation agents

A single plasma exchange can remove 20 mg or more of copper. It can also remove metabolic toxins that may have accumulated.