Wilson Disease Presenting with New Clinical and Biochemical Lab Findings: A Case Report and Review of Literature
Article Information
Publication Timeline
- Received05 November 2025
- Accepted06 December 2025
- Published
Abstract
Introduction: Wilson disease, an inherited autosomal recessive disorder of copper metabolism, is characterized by pathological copper accumulation. The disease is potentially treatable and usually caused by mutations in the ATP7B gene, encoding the transmembrane copper-transporting adenosine triphosphatase. Despite its well-documented neurological and hepatic manifestations, electrolytes disturbances, including hypermagnesemia, remained under-reported and rarely associated with the disease.
Case Presentation: A married Asian, Pakistani Punjabi, male from a middle-class family in his late 20s was admitted to the neurology ward of a tertiary care hospital with no previous medical history of disease. Initial assessments illustrated vital signs: body temperature 98°F, blood pressure 120/70 mmHg, random blood glucose level 81 mg/dl, pulse 82 beats per minute, oxygen saturation 98%, and hydration status (input: 1500 ml, output: 1000 ml). Physical examination revealed pallor on face and normal eyes, but mild silvery-brown edges in the corneas of both eyes (Kayser-Fleischer rings). Screening with mini nutrition assessment - short form, indicated malnourishment with a score of 4 (score: 0–7 signifies malnourished), accompanied by a body mass index of 20.43 kg/m². The subjective global assessment form showed a 10.93% weight loss within one month. Hypermagnesemia was prominent, with serum magnesium levels exceeding 2.2 mg/dl. Liver function tests revealed elevated aspartate transaminase levels.
Conclusion: Wilson’s disease patients could develop severe malnutrition after the onset of the disease, hypermagnesemia, a dry white tongue, mouth sores despite good oral hygiene, and fatigue due to low oxygen supply, as indicated by low levels of haemoglobin in the blood.
References
- Sandahl TD, Laursen TL, Munk DE, Vilstrup H, Weiss KH, Ott P. The prevalence of Wilson’s disease: an update. Hepatology. 2020;71(2):722 -732. doi:10.1002/hep.30911 [Google Scholar][Crossref]
- Członkowska A, Litwin T, Dusek P, Ferenci P, Lutsenko S, Medici V, et al. Wilson disease. Nat Rev Dis Primers. 2018;4(1):21. doi:10.1038/s41572-018-0018-3 [Google Scholar][Crossref]
- Patil M, Sheth KA, Krishnamurthy AC, Devarbhavi H. A review and current perspective on Wilson disease. J Clin Exp Hepatol. 2013;3(4):321 -336. doi:10.1016/j.jceh.2013.06.002 [Google Scholar][Crossref]
- Roberts EA, Schilsky ML. Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008;47(6):2089-2111. doi:10.1002/hep.22261 [Google Scholar][Crossref]
- Poujois A, Woimant F. Challenges in the diagnosis of Wilson disease. Ann Transl Med. 2019;7(Suppl 2):S67. doi:10.21037/atm.2019.02.43 [Google Scholar][Crossref]
- Leung M, Aronowitz PB, Medici V. The present and future challenges of Wilson’s disease diagnosis and treatment. Clin Liver Dis (Hoboken). 2021;17(4):267-270. doi:10.1002/cld.1041 [Google Scholar][Crossref]
- Poon KS, Teo ZH, Yap JH, Koay ES, Tan K. Challenges in molecular diagnosis of Wilson disease: viewpoint from the clinical laboratory. J Clin Pathol. 2020;73(4):231-234. doi:10.1136/jclinpath-2019-206054 [Google Scholar][Crossref]
- Cohen H. How to write a patient case report. Am J Health Syst Pharm. 2006;63(19):1888 -1892. doi:10.2146/ajhp060182 [Google Scholar][Crossref]
- Andreou A, Trantza S, Filippou D, Sipsas N, Tsiodras S. COVID-19: The potential role of copper and N-International Journal of Medical and All Body Health Research www.allmedicaljournal.com acetylcysteine (NAC) in a combination of candidate antiviral treatments against SARS-CoV-2. In Vivo. 2020;34(3 Suppl):1567 -1588. doi:10.21873/invivo.11946 [Google Scholar][Crossref]
- Güngör Ş, Selimoğlu MA, Varol Fİ. Nutritional assessment of children with Wilson’s disease: single center experience. Turk Pediatri Ars. 2019;54(4):246-255. doi:10.14744/TurkPediatriArs.2019.42402 [Google Scholar][Crossref]
- Aggarwal A, Bhatt M. Wilson disease. Curr Opin Neurol. 2020;33(4):534 -542. doi:10.1097/WCO.0000000000000843 [Google Scholar][Crossref]
- Shribman S, Poujois A, Bandmann O, Czlonkowska A, Warner TT. Wilson’s disease: update on pathogenesis, biomarkers and treatments. J Neurol Neurosurg Psychiatry. 2021;92(10):1053-1061. doi:10.1136/jnnp-2021-326123 [Google Scholar][Crossref]
- Schilsky ML, Roberts EA, Bronstein JM, Dhawan A, Hamilton JP, Rivard AM, et al. A multidisciplinary approach to the diagnosis and management of Wilson disease: Executive summary of the 2022 Practice Guidance on Wilson disease from the American Association for the Study of Liver Diseases. Hepatology. 2023;77(4):1428-1455. doi:10.1002/hep.32805 [Google Scholar][Crossref]
- Barber RG, Grenier ZA, Burkhead JL. Copper toxicity is not just oxidative damage: Zinc systems and insight from Wilson disease. Biomedicines. 2021;9(3):316. doi:10.3390/biomedicines9030316 [Google Scholar][Crossref]
- Abbassi N, Bourrahouat A, Bedoya EC, Belmalih A, El Hanafi FZ, Bost M, et al. Epidemiology, clinical features, and mortality rate of Wilson disease in Moroccan children: A pediatric case series. Arch Pediatr. 2022;29(6):453-458. doi:10.1016/j.arcped.2022.05.013 [Google Scholar][Crossref]
- Salmon MK, Cohen WG, Hu F, Aydin A, Coskun AK, Schilsky M, et al. Taste and smell function in Wilson's disease. J Neurol Sci. 2024;459:122949. doi:10.1016/j.jns.2024.122949 [Google Scholar][Crossref]
- Kröner PT, Aby ES, Wijarnpreecha K, Palmer W. Wilson disease-related cirrhosis is associated with increased odds of hemolytic anemia. J Evid Based Med. 2022;15(1):15-18. doi:10.1111/jebm.12463 [Google Scholar][Crossref]
- Shankar M, Nayaka M, Aralapuram K, Gurusiddaiah SC. Wilson’s disease presents as recurrent hypokalemic muscle paralysis. Indian J Nephrol. 2023;33(4):292-295. doi:10.4103/ijn.ijn_143_22 [Google Scholar][Crossref]
- Culpepper T, Kelkar AH. Undiagnosed Wilson’s Disease and Fibromyalgia Masking Bowel Perforation. Cureus. 2021;13(2):e13504. doi:10.7759/cureus.13504 [Google Scholar][Crossref]
- Sanjeev VK. Serum Magnesium as an Effective Tool in Monitoring the Control of Type II Diabetes Mellitus [dissertation]. Coimbatore: PSG Institute of Medical Sciences and Research; 2015. [Google Scholar][Crossref]
- Kim D, Park YG, Park JH, Park J. Dysphagia in Wilson’s Disease: A Case Report of One-Year Follow-Up. Journal of the Korean Dysphagia Society. 2021;11(1):82-86. doi:10.34160/jkds.2021.11.1.012 [Google Scholar][Crossref]
- Seessle J, Gohdes A, Gotthardt DN, Pfeiffenberger J, Eckert N, Stremmel W, et al. Alterations of lipid metabolism in Wilson disease. Lipids Health Dis. 2011;10:83. doi:10.1186/1476-511X-10-83 [Google Scholar][Crossref]
- da Silva Santos PS, Fernandes KS, Fraige A, Gallottini M. Dental management of a patient with Wilson's disease. Gen Dent. 2015;63(3):64-66. [Google Scholar][Crossref]
- Shribman S, Marjot T, Sharif A, Vimalesvaran S, Ala A, Alexander G, et al. Investigation and management of Wilson's disease: a practical guide from the British Association for the Study of the Liver. Lancet Gastroenterol Hepatol. 2022;7(6):560 -575. doi:10.1016/S2468-1253(22)00004-8 [Google Scholar][Crossref]
- Pawaria A, Sood V, Lal BB, Khanna R, Bajpai M, Alam S. Ninety days transplant free survival with high volume plasma exchange in Wilson disease presenting as acute liver failure. J Clin Apher. 2021;36(1):109-117. doi:10.1002/jca.21848 [Google Scholar][Crossref]
- Guillaud O, Dumortier J, Couchonnal-Bedoya E, Ruiz M. Wilson disease and alpha1-antitrypsin deficiency: a review of non-invasive diagnostic tests. Diagnostics (Basel). 2023;13(2):256. doi:10.3390/diagnostics13020256 [Google Scholar][Crossref]
- Xu ZX, Zhou YY, Wu R, Zhao YJ, Wang XP. Brain iron deposition and whole-exome sequencing of non-Wilson's disease hypoceruloplasminemia in a family. J Neurorestoratol. 2023;11:100027. doi:10.1016/j.jnrt.2022.100027 [Google Scholar][Crossref]
- Tovaru S, Parlatescu I, Dumitriu AS, Bucur A, Kaplan I. Oral Complications Associated With D‐Penicillamine Treatment for Wilson Disease: A Clinicopathologic Report. J Periodontol. 2010;81(8):1231-1236. doi:10.1902/jop.2010.090736 [Google Scholar][Crossref]
How to Cite
Jawad, M., Komal, M., Haider, A., & Abedi, M. (2026). Wilson Disease Presenting with New Clinical and Biochemical Lab Findings: A Case Report and Review of Literature. International Journal of Medical and All Body Health Research, 7(1), 54-58. https://doi.org/10.54660/IJMBHR.2026.7.1.54-58
Jawad, Muhammad, et al. "Wilson Disease Presenting with New Clinical and Biochemical Lab Findings: A Case Report and Review of Literature." International Journal of Medical and All Body Health Research, vol. 7, no. 1, 2026, pp. 54-58. https://doi.org/10.54660/IJMBHR.2026.7.1.54-58.
Jawad, M., Komal, M., Haider, A. and Abedi, M. (2026) 'Wilson Disease Presenting with New Clinical and Biochemical Lab Findings: A Case Report and Review of Literature', International Journal of Medical and All Body Health Research, 7(1), pp. 54-58. doi: 10.54660/IJMBHR.2026.7.1.54-58.
Jawad M, Komal M, Haider A, Abedi M. Wilson Disease Presenting with New Clinical and Biochemical Lab Findings: A Case Report and Review of Literature. International Journal of Medical and All Body Health Research. 2026;7(1):54-58. doi:10.54660/IJMBHR.2026.7.1.54-58
Similar Articles
- Leukocyte Adhesion Deficiency Type 1 in a Neonate Presenting with Delayed Umbilical Cord Separation and a Non-healing Inguinal Ulcer: A Case Report Vol 7, Issue 4 (2026)
- Physiotherapy Management of Right-Sided Cervical Radiculopathy with Coexisting Trapezitis: A Case Report Vol 7, Issue 3 (2026)
- Colchicine toxicity: Accidental Plant Poisoning with Colchicum Autumnale Resulting in Multiorgan Failure: A Case Report Vol 7, Issue 3 (2026)
- Unusual Cystic Duct Anatomy with Single Gallbladder Encountered During Laparoscopic Cholecystectomy: A Rare Case Report Vol 7, Issue 2 (2026)
- Rapidly Developing Giant Ascending Aortic Pseudoaneurysm Presenting as Constrictive and Tamponade-like Physiology After Coronary Artery Bypass Grafting: A Case Report Vol 7, Issue 2 (2026)
Find this Article on
Google Scholar Semantic Scholar OpenAlex Scilit Crossref ResearchGate BASEA newly published article may take a few days to appear on these services.