Acute-on-Chronic Liver Failure in a 13-Year-Old Patient With Wilson's Disease Due to Dengue Virus Infection: A Case Report.

Acute-on-chronic liver failure (ACLF) is characterized by acute hepatic decompensation in patients with chronic liver disease and is a clinical syndrome associated with high short-term mortality. Most commonly, the underlying cause of chronic liver disease is known prior to the acute decompensation, which is precipitated by another factor. We present the case of a 13-year-old male with previously undiagnosed Wilson's disease (WD) who developed rapidly progressive ACLF precipitated by dengue virus infection, culminating in multiorgan failure and death. This case highlights the diagnostic challenges and poor prognosis associated with WD-related ACLF and underscores the importance of considering underlying chronic liver disease when hepatic dysfunction appears disproportionate to the expected course of dengue infection in endemic areas. We also discuss current definitions of ACLF, the medical literature pertaining to dengue virus infection and liver failure, and ACLF in the context of WD.