A Case of Wilson’s Disease

AGE : 14 yr

SEX : female

DIAGNOSIS : ‘Wilson’s disease’.

She was admitted to a renowned super specialty hospital in Pune where the routine allopathic drugs failed to provoke a positive response.

The specialists there had declared that nothing further could be done, since there was pancytopenia with platelet depletion (heavy hemorrhage) and also septicaemia due to bacterial peritonitis.

Appearance of the patient and case history.

• The patient sitting in front of me was a pale, lean, girl with very sharp eyes and active perception.
• Her intelligence prevailed despite her grave condition. This girl came from a semi-rural background, a village, very near Pune city.
• She had a bob-cut, with dry lusterless hair. She wore a frock with flower-print. She was a well-mannered girl, compared to her arrogant father. I found her gait disturbed since both her knees were internally rotated which interlocked while walking.
• She was admitted for a corrective operation for her knees but suddenly she showed some symptoms (chills with fever, bloody sputum, blood in stool) for which she was investigated to confirm the diagnosis of Wilson’s disease.

 

Wilson’s disease –

• Hereditary syndrome transmitted as an autosomal recessive trait in which a decrease of ceruloplasmin permits accumulation of copper in various organs (brain, liver, kidney and cornea) associated with increased intestinal absorption of copper.
• This syndrome is characterized by degenerative changes in the brain, cirrhosis of liver, haemolysis, splenomegaly, tremor, muscular rigidity, involuntary movements, spastic contractures, psychic disturbances, dysphagia, progressive weakness and emaciation.
• Life-long D-penicillamine treatment is the only option in allopathy (Its prolong use may cause iron deficiency anaemia),
• The other option being liver transplant which costs about one crore Indian rupees while the post transplant expenditure is more than 2 thousand/day, including all immunosuppressive drugs to avoid organ rejection.
• It is a boon that Homoeopathy is aimed at treating the person and not the disease. The disease by any name is never frightening for any eminent Homoeopath.

 

Her complaints were:

 Pain in abdomen – epigastric region.

Nature of pain – lightening with sudden onset and decline.

< Lying on back.                 > Lying on sides.

< 9:30 pm.                          > Bending double.

< Jerk.

< Movement.

< Sitting.

 Pain in calves, severe aching.

< Morning.                > Warm bath after.

< Waking on.

 Pitting oedema on both ankles.

< Prolong sitting.      > Walking.

< Hanging legs.

Trembling of lower limbs  > Pressure.

 Backache  – Aching pain.

< Walking.                                    > Lying down.

< Squatting.                                  > Rest.

< Ascending and descending stairs.

Bleeding from body orifices i.e. nose, rectum etc.

P/R bleeding (blood in stool) since 1 month.

Bloody sputum and blood from nose since 1 month.

 Deformity in both knees. (Lt) to (Rt) disturbed gait…knees interlocked while walking. Cannot ascend stairs at all.

 

• Investigation :

• Urine : Urinary copper: 357-mcg/24 hrs. Ceruloplasmin : 16 mg.

• Blood : HB: 6.2 gm%    TLC: 5000/mm3 Platelet : 56,000/ mm3

[ Just 1 month before platelets were adequate. HB : 9.2 ]

• Bone Marrow: Spur cells. Hypo cellular marrow and megakaryocytes.

• USG abdomen and pelvis: Shrunken liver with chronic parenchymal destruction with raised portal pressure. Cirrhotic changes.

 

• Past History :

–         Chicken pox and measles in childhood.

–         Weight loss since 3 years.

–         Fall on back 3 years ago, injury to spine.

 

• Physical Generals :
  • Appetite     : Normal.
  • Desire         : Meat⁺⁺, Spicy⁺⁺⁺, Milk⁺⁺, Green Vegetable.
  • Aversion     : Sweet⁺, Bitter.
  • Thirst          : Thirsty. Small quantity at small intervals.
  • Perspiration     : Decreased.
  • Stool           : P/R bleeding since 1 month.
  • Sleep           : Sound. Lying on abdomen. Covering required all over the body.
  • Dreams       : Of family members.
    Eyes            : Bluish  (Bil) – Kaiser Fleischer ring on cornea (indication of Wilson’s disease).
  • Thermals    : CHILLY patient.

I CONTINUED THE CONSULTATION AS FOLLOWS:

 

How is your nature?

• I am very straightforward and do not tolerate anybody not listening to me.
• My younger brother always disobeys me.
• I get very angry and sometimes beat him. I like all my things in their proper place and nobody should misplace them.
• If so, I scream at the person who does it.

 

Anything else?

• Father: She is very obstinate. You know what she did in the hospital? There, she was on saline and was injected many times. The doctor was trying to calm her, but do you know what she said?

• “She said, don’t teach me. Only I know how much pain and suffering these injections give me … You will not understand this unless you are tortured with these needles yourself.”
  • Literally I felt very embarrassed.
  • She said “I don’t think I had said anything wrong. When you know that someone is suffering, you should not give him false promises, that they will be cured. Every time they promised me that it would be the last injection. But the same was repeated again within few hours.”

Any fear?

• Father, “No. She is courageous. It was only when she was very small, that she feared ghosts.”

How is her progress in the school?

• Father: “She is not a first ranker but definitely an intelligent student. She is very ambitious and wants to be a rich and famous personality.”

Any disturbing incident recently?

• Father: “No. She doesn’t take anything seriously. Even now, all the family members are worried, but she is not sad or weeping. She is indeed a brave girl. (I asked her about her disease and what she felt about it? She replied spontaneously, “I am sure that one day, I will be able to walk properly.”)

What are your hobbies?

• I like to draw pictures and read my course books and stories.

 

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