HOW COME MY GENOTYPE IS SS?
By Fatima Garba Mohammed
- Doctors from Around the world say it’s 99.999999% Impossible
Adeola ‘Wamiri’ Adeyemi was only three years old when her parents discovered they had on their hands an impossibility. The question, ‘How Come?’ was on everyone’s lip. The doctors were flabbergasted. It seemed they were witnessing a well-known maxim in medicine, which states, NEVER SAY NEVER. Or was it something else?
The religious ones among the medical and laboratory personnel at the dozens of hospitals the parents took the infant to attributed it to all things being possible in medicine.
However, one of Wamiri’s father’s friends, a medical doctor, though fervidly religious, was always careful to relegate his faith to the background in favour of his science. Not having ever come across such a situation in his years of medical practice – nor anywhere in the medical textbooks – he concluded someone was trying to hoodwink his friend.
‘She must be a bastard,’ he concluded one day within himself and, after confiding his suspicions to his friend, carted the child and her parents off for a paternity test. Result, 100% positive.
First Hospital Admission
At just under three years of age, Wamiri had severe splenic enlargement and was found dangerously short of blood. Her diagnosis with sickle cell anaemia (HbSS) was a touch and go, but unraveling where her SCD came from would remain a cause at once for wonder, perplexity, bemused incredulity, suspicion – and gossip.
Second Hospital Admission
True to the character of sickle cell anaemia, the child fell ill from time to time – malaria, mild pain, tiredness, etc but oftentimes not severe enough to warrant anything outside management at home.
At the age of 12, Wamiri had another deadly visitation of spleen enlargement, abdominal tautness and extreme blood shortage. She was hospitalized for the second time.
‘The Whole Saga Nearly Rocked The Marriage’
The Big Puzzle
The Adeyemis have four children – three girls and one boy. Both the parents are AA, so are all the children except Wamiri, whose Hb (tested again and again at several laboratories, including government-owned Isolo General Hospital, Lagos) is SS.
Is it possible Wamiri’s mom took home the wrong child?
Not at all, says Mrs. Maria Adisa, Proprietress of Blessed Mary Hospital, Ikotun, where Wamiri was born 26 years ago.
‘I remember the day she was born very well,’ Mrs. Adisa tells Sickle Cell News ‘her mother was the only expectant mother on our ward and Wamiri was the only child born on that day!’
Mrs. Adisa was later apprised of the uncertainties surrounding the child’s genotype – a riddle she still rues to this day.
‘Like everyone else, I am flabbergasted,’ she says.
Is it possible the parents are not AA?
The couple has been to public and private medical facilities to verify their blood genotype, yet the results have always been the same (AA).
Is it possible the electrophoretic machines used in all the facilities the parents and the child were taken to could not detect the complex tapestry of some rare genotypes masquerading as AA?
After all there are hundreds of genotypes, many of which most machines available today are unable to pin down.
The troubling issue of Wamiri’s genotype may have died down at home now, but in those early years, the matter very nearly rocked the marriage. How can a man be AA and have a child with sickle cell anaemia? The woman must explain where she got the baby from! ‘I lived with the family during those tumultuous years when everyone exercised their fancy pondering the N64m question,’ recalls Deaconness Lewis Olubunmi, Wamiri’s paternal aunt. Somehow, sanity prevailed and the marriage survived the storm.
The close and uncanny resemblance between and among Wamiri and her siblings was one factor which contributed to the stability of the union and the erosion of whatever doubts anyone might have. However, many medical authorities say resemblance carries little or no weight when paternity disputes arise. After all, some say, even dogs resemble their owners!
A child might resemble his matrilineal relations but not his father’s (and vice versa) – but then one might quickly – if not conveniently – forget Wamiri, with HbSS could not have been the offspring of parents who did not have at least one sickle gene in their loins. A classical Sherlock Holmes mystery.
Wamiri’s Father Turns To God
Mr. Adebowale Adeyemi was a young man of 35 when the perplexing issue of genotype fell unto his lap. His education had suffered after his father’s death in 1967, when he was only 12 years old.
Despite his lack of classroom education, he well knew the surface implications of genotype. Even if he was not perspicacious enough, he had an army of well-educated friends and relatives to impress on him the endless underhand implications of a child having a genotype different from his parent.
After medical and laboratory science had failed to unravel the mystery, Mr. Adeyemi decided there was nothing to do but take the matter to God. So he took his wife, Bolanle and Wamiri, then six years old, to consult a well-known prophet.
On such occasions, the practice is to pray; after which the man of God relays the message or instruction from Above. But just as the family stepped into the premises, the prophet stopped them in their tracks:
‘That child with you,’ said he to the bewildered parents, ‘is unique among all your children. Pray, pray hard so the darkness of untoward health does not overcome her destiny!’
Wamiri Turns To The Biological Sciences For Explanation
It doesn’t take any perceptive child long to be curious about their own history. For Wamiri, a look there, a word there, whisperings here and there, subtle gestures and snide remarks cumulatively built up and solidified into a burning thirst for knowledge – and self-discovery.
At the Lagos State University (LASU), Wamiri opted for Biology. By design or coincidence, she had honed in on a course as good as medicine to unravel the mystery of her genes. Incidentally, LASU required all fresh to do a genotype test. Wamiri’s result? SS.
At the University of Lagos, Wamiri equally undertook masters in Biology and is on the cusp of graduating. The courses she took in Genetics did little to assuage her inflamed curiosity. So it was up to her to find out for herself.
‘During one of my researches to ascertain what could be the reason for the difference in my genotype, I stumbled on a type of mutation called ‘de novo mutation’ which is a genetic alteration that is present for the first time in one family member as a result of a variant (or mutation) in a germ cell (egg or sperm) of one of the parents, or a variant that arises in the fertilized egg itself during early embryogenesis.’ I have absolutely no doubt of who my parents are, she says.