Wilson disease

Liver biopsy from a 4-year-old girl whose 10-year-old sister presented with liver failure and cirrhosis secondary to previously unrecognized Wilson disease. Liver biopsy was performed because her serum ceruloplasmin was low (4.0 mg/dL) and serum aminotransferases were repeatedly two to three times normal. Left panel: Low power shows portal fibrosis, mild portal inflammation, and fatty infiltration (Masson trichrome). Right panel: High power view shows fatty infiltration of hepatocytes and two glycogen nuclei (Masson trichrome).