A CASE REPORT: WILSON’S DISEASE ASSOCIATED WITH HYPERSENSITIVITY REACTIONS DUE TO PENICILLAMINE

Vaibhavi Marawar, Sudhanshu Sen, *S. P. Nayak, Mohit Buddhadev and G. S. Chakraborthy

ABSTRACT

Wilson's disease is a rare genetic disorder characterized by copper metabolism dysfunction, leading to copper accumulation in various organs, predominantly the liver and brain. We present a case of a 52-year-old male with a history of hypotension and liver cirrhosis who presented with ill-defined erythematous plaques and exfoliation of skin over the face, chest, and back, sparing the skin over the buttocks and bilaterally up to the knees. This presentation followed the administration of intravenous penicillamine, which led to hypersensitivity reactions. Laboratory investigations revealed elevated copper levels, suggestive of Wilson's disease, along with findings of liver parenchymal disease, thickened gallbladder wall, splenomegaly, raised corticoechogenicity of bilateral kidneys, and gross ascites on abdominal ultrasonography. Despite supportive care with intravenous fluids, analgesics, antiemetics, and antibiotics, the patient's skin manifestations persisted, albeit with improvement in other symptoms. The patient was discharged with incomplete resolution of skin rashes and advised to apply soft paraffin cream and avoid sunlight exposure. This case highlights the importance of considering Wilson's disease in patients presenting with skin manifestations, especially following drug administration, and underscores the need for comprehensive management to address both acute symptoms and underlying disease pathology.

Keywords: Wilson's Disease, Hypersensitivity Reaction, Liver Cirrhosis, Skin Manifestations.