Medical case narrative
A 13-year-old whose behaviour was blamed on his family's troubles
What happened
A 13-year-old boy's behavioural and emotional problems were attributed to a series of major life stresses — his parents' divorce, his father's remarriage, the birth of three stepsiblings — under a diagnosis a later review records as "adjustment reaction with mixed disturbance of emotion and conduct." The later review's case table gives five years from that initial framing to the final diagnosis. This is the thinnest entry in this batch, and it is labelled as such rather than padded.
What it looked like
Physically and verbally abusing siblings and his stepmother; inappropriate affect — tearfulness, inappropriate laughter — temper tantrums, talking to himself, mood swings; then the physical signs: slurred speech, clumsiness, frequent nighttime urination, and academic decline. On examination, a later review reports mildly abnormal limb movements, Kayser-Fleischer rings, and an enlarged liver and spleen.
What the labs found
Wilson's disease. The 2024 review recounting his case reports a 24-hour urine copper of 304 μg, low serum copper and ceruloplasmin, a liver biopsy showing elevated copper, a normal EEG, and a CT scan showing brainstem and cerebral atrophy with low-density areas in the basal ganglia. Those details could not be checked against the original 1986 report itself, whose full text is paywalled — its published abstract confirms the boy, the behavioural masking after life stresses, and the disease, and no more. The urine copper figure in particular is printed here as recounted, not as confirmed.
What changed
Trientine, a copper-binding drug, was started; he was referred to social work for the family issues and given special education for his cognitive deficits. Neither source reports a longer-term outcome, and this entry does not invent one.
The test that told the story
The Wilson's disease workup — copper studies and the eye and liver examination (as recounted in a 2024 review; the original report's full text was not available to check them against).
Sources: Carr A. & McDonnell D.J., Journal of Child Psychology and Psychiatry 1986 (primary case report, abstract only); McCormick et al., PLOS Mental Health 2024 (review recount and case table).