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Wilson disease in a Nigerian child: a case report

Christopher I Esezobor1*, Nora Banjoko2, Adekunle Rotimi-Samuel3 and Foluso Ebun A Lesi1

Author Affiliations

1 Department of Paediatrics, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria

2 Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Mushin, Lagos, Nigeria

3 Department of Ophthalmology, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria

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Journal of Medical Case Reports 2012, 6:200 doi:10.1186/1752-1947-6-200

Published: 16 July 2012

Abstract

Introduction

Wilson disease is rarely reported among African children. This report describes the second case report of a Nigerian child with Wilson disease in three decades.

Case presentation

An eight-year-old African boy presented with generalized oedema and ascites and proteinuria. Over the next three weeks he developed conjugated hyperbilirubinaemia, severe coagulopathy and prominent extrapyramidal features consisting of rigidity, tremors at rest and in action, shuffling gait, slurred speech and emotional lability. Slit-lamp examination of his eyes revealed Kayser-Fleischer rings and sunflower cataracts. His serum caeruloplasmin level was 5mg/dL. Using the scoring system proposed by the 8th International Meeting of Wilson Disease and Menkes Disease, a diagnosis of Wilson disease was made.

Conclusions

Wilson disease does occur in African children, although the diagnosis is rarely made. A diagnosis of Wilson disease should be entertained in the evaluation of African children presenting with liver dysfunction and/or extrapyramidal neurological features.