Medical case narrative
Twelve years of "paranoid schizophrenia" — diagnosed only because his brother was
What happened
A young man in Canada (unnamed in the published report) had his first acute psychosis at 18, with recurrences at 22 and 23, and was treated as having paranoid schizophrenia for 12 years before anyone found the medical cause — at age 30, and then only because his younger sibling was diagnosed with Wilson's disease, which prompted testing of him. No workup ordered for his own symptoms had found it.
What it looked like
Over the years: social decline, academic failure, insomnia, concentration difficulties, weakness, and unexplained abdominal discomfort, nausea, and vomiting while on treatment; later, abnormal gait, kyphosis, and joint problems needing physiotherapy, and parkinsonism — stiffness and slowness — that was almost uncontrollable and was aggravated by his antipsychotic medication.
What the labs found
Wilson's disease. A later review of his case reports Kayser-Fleischer rings, a low serum ceruloplasmin, and a liver biopsy compatible with Wilson's disease, with a normal CT scan; no numeric values were published in any source. The fuller details of his case, including the sibling-triggered discovery, come from that later review's account of the original 1992 French-language report, whose published abstract confirms the core: onset at 18, the paranoid schizophrenia diagnosis, the 12-year delay, and the outcome below.
What changed
D-penicillamine produced partial neurological improvement, but his movement and autonomic symptoms persisted — the original report attributes the limited response to chelation alone to the diagnostic delay. His psychiatric symptoms improved on fewer antipsychotics than the previous twelve years had required, but the antipsychotics could not be stopped: when they were, the psychosis returned, and he was restabilised at a lower dose. The improvement was sustained at 15-month follow-up, with intermittent abdominal pain and nausea continuing.
The test that told the story
The Wilson's disease workup — ceruloplasmin, copper studies, eye examination, and liver biopsy (as recounted in a later review of the case) — ordered only after the same diagnosis was made in his brother.
Sources: Saint-Laurent M., Canadian Journal of Psychiatry 1992 (primary case report, abstract); McCormick et al., PLOS Mental Health 2024 (later review recounting the case in fuller detail); Bidaki et al. 2012 (a further recount).