Fatal Crossroads: D-penicillamine and Disseminated Intravascular Coagulation in Wilson's Disease.

A 13-year-old male with Wilson's disease presented with progressive edema, jaundice, and neuropsychiatric symptoms. His evaluation revealed advanced hepatic dysfunction (Child-Pugh Class C), confirmed by biochemical, imaging, and histopathological findings. Despite initial stabilization, he was readmitted with acute gastrointestinal bleeding, hypotension, and laboratory evidence of disseminated intravascular coagulation (DIC), which rapidly progressed despite aggressive management. This case underscores the potential risk of DIC with D-penicillamine in Wilson's disease and highlights the need for vigilance, early recognition, and consideration of alternative treatments in susceptible patients.