Ghana records first Wilson’s disease at Korle Bu Teaching Hospital

The Child Health Department of the Korle Bu Teaching Hospital (KBTH) has recorded a rare case of Wilson’s Disease in a 13-year-old boy.

The condition, believed to be the first in the country, is said to affect one out of 30,000 population in developed countries. The boy was diagnosed with the fatal genetic disease after his mother, a trader, detected his deteriorating handwriting.

The Head of Neuro-Developmental Clinic, Department of Child Health, KBTH, Professor Ebenezer Badoe, who made the diagnosis after several tests, however, said the disease was treatable.

He said the young boy could live a normal life through medication, but was concerned about the cost involved, saying the patient needed GH¢450 every month to stay alive.

Wilson’s disease is an inherited disorder that causes too much copper to accumulate in the organs. It causes copper levels to build up in several organs, especially the liver, brain and eyes.

In Wilson’s disease, copper is not eliminated properly and instead accumulates, possibly to a life-threatening level. Symptoms typically begin between the ages of 12 and 23 and they include swelling, fatigue, abdominal pain and uncontrolled or poorly coordinated movements.

Treatment often includes medication that can prompt the organs to release copper into the bloodstream. Once it is in the bloodstream, it can then be eliminated from the body through the kidneys.

Diagnosis

Prof. Badoe said he became alarmed when he got into contact with the boy because mostly, the first symptom of the disease presented with jaundice before affecting the other organs such as the liver and kidney.

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However, he said, although the boy did not contract jaundice, his condition had crossed the jaundice stage and entered his brain causing him to lose his motor skills, hence the deteriorating handwriting, and a change in his gait.

The paediatric neurologist said because the disease was rare and needed both parents to have the genes to be affected, he requested an advanced genetic test for both parents and the child which was done in the United States of America (USA) at a cost of $8,000, with funding from a non-governmental organisation, Reg Disease Ghana.

He said the test came back positive for both parents, which confirmed that the boy was presented with an ‘Autosomal recessive inheritance’, which is the way a genetic trait or condition is passed down from parent to child.

Prof. Badoe said unlike sickle cell disease which was also an autosomal recessive inheritance disease, the condition was common among the population, and therefore, was easy for one to be diagnosed with it, unlike the Wilson’s disease, which he said, was a rare case.

Eye symptoms

He said the boy’s condition had deteriorated to the extent that he had a gray ring around the edge of the corneas in the eyes, which he referred to as Kayser-Fleischer rings — a sign of copper in the eyes.

Prof. Badoe said the young boy needed lifelong treatment, saying stopping the treatment may cause acute liver failure which could lead to death. The paediatric neurologist, therefore, called on well-meaning Ghanaians, philanthropists and institutions who had the means to help buy the drugs for the little boy to keep him alive.

He said the sad thing was that though the boy’s health was improving after he put him on two months of supply of the drug, his health would deteriorate when the drug ran out and that could lead to death.

He stressed the need for teachers and caregivers to be given the needed training to pick simple changes in the children under their care so that they could report for further study to be done for early diagnosis of conditions among children.

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The paediatric neurologist praised the mother of the boy, saying through her vigilance she was able to detect that there was something wrong with her son and therefore sought prompt medical attention, leading to the diagnosis.

Speaking with the mother (name withheld) on telephone, she told the Daily Graphic that she noticed her son was not bringing homework to the house so she often contacted his mates around to copy the work and do it for him to copy.

She said even when she did the work for the child to copy into his book, he still refused with the excuse that he could not write. She became alarmed and went to the school to enquire but his teacher told her he had become slow in class so they normally did not engage him to copy his homework since he would waste their time.

She then confided in a nurse in church who offered to help at her clinic at Kasoa, but they later realised it was beyond them and subsequently transferred the boy to the Accra Psychiatric Hospital, where she said, the result of the first MRI attracted the entire medical staff.

She said they all concluded that the boy’s condition was rare and therefore should be transferred to KBTH, where he was finally diagnosed with the disease.

Korle-Bu Teaching Hospital (Wilson's disease