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A 15-year-old girl presented with acute hepatic failure showing ascites and hepatic encephalopathy, accompanied by hemolytic anemia. She was diagnosed as having fulminant Wilson's disease (FWD). Plasma exchange (PE), continuous hemodiafiltration (CHDF) and Dpenicillamine administration were started immediately. Copper [24,000 jig] was removed by PE and CHDFover three days, which relieved the jaundice and the consciousness disorder. A successful liver transplant followed. FWDprogresses rapidlydoi:10.2169/internalmedicine.42.967 fatcat:zp3hrqmvina6xppcedtvm6djhu