Rheumatoid Arthritis and Coexıiting Parkinson

Abstract

It is a commonly seen condition that the hand deformities which are seen in Parkinson disease (PD) mistakenly diagnosed as Rheumatoid arthritis (RA) so PD and RA have been associated with each other in the literature. Looking for the another view, in autoimmune diseases, such as RA, there is a chronically high concentrations of inflammatory mediators product over long periods of time and it has been hypothesized that these patients may be at increased risk for neurodegenerative diseases such as PD. To contribute to a few recently published reports, we describe five patients, over 65 years old, with a primary diagnosis of RA and coexisting PD and we discuss possible pathogenetic link between RA and PD. The coexisting cases in this report are most probably incidental but the prevalence of coexisting of RA and PD may be higher than that of regularly thought. The present report is draw attention to the possibility of coexisting and to keep in mind the possibility of developing neurodegenerative disorders due to the chronic inflammation in the course of patients with RA

Keywords

• Rheumatoid arthritis, Parkinson disease, deformity

Rheumatoid Arthritis and Coexıiting Parkinson

Öz

Literatürde Parkinson hastalığında (PH) görülen el deformitelerinin yanlışlıkla romatoid artrit (RA) tanısı alması sık görülen bir durumdur ve RA ile PH bu nedenle birbirleriyle ilişkilendirilmektedir. Bir başka açıdan ise, RA gibi otoimmün patolojilerde yüksek düzeylerde inflamatuar mediatör üretimi vardır ve bu hastalar PH gibi nörodejeneratif hastalıklar açısından yüksek risk altında olabilirler. Bu yazıda; yeni yayınlanmış literatürlere katkı sağlamak amacıyla, PH’nın eşlik ettiği RA tanısı olan 65 yaşın üzerinde beş hasta sunulmakta ve RA ile PH arasındaki olası patogenetik ilişki tartışılmaktadır. Bu olgular çok büyük ihtimalle tesadüfen saptanan hastalar olmakla birlikte, RA ve PH birlikteliğinin prevelansı sanılanın çok üzerinde olabilir. Bu yazı; iki hastalığın muhtemel birlikteliğine ve RA hastalarının seyri sırasında kronik inflamasyona bağlı nörodejeneratif hastalıkların gelişme olasılığına dikkat çekmektedir

Anahtar Kelimeler

• Romatoid artrit, parkinson hastalığı, deformite

Kaynakça

1. Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet 2010;376(9746):1094-108.
2. Wirdefeldt K, Adami HO, Cole P, Trichopoulos D, Mandel J. Epidemiology and etiology of Parkinson's disease: a review of the evidence. Eur J Epidemiol 2011;26 Suppl 1:S1-58.
3. Melikoglu MA, Sezer I, Kacar C. Rheumatoid-like hand deformities in Parkinson disease. J Clin Rheumatol 2007;13:236–7.
4. Rugbjerg K, Friis S, Ritz B, Schernhammer ES, Korbo L, Olsen JH. Autoimmune disease and risk for Parkinson dis- ease: a population-based case-control study. Neurology 2009;73(18):1462-8.
5. Kogure T, Tatsumi T, Kaneko Y, Okamoto K. Rheumatoid Arthritis Accompanied by Parkinson Disease. J Clin Rheumatol 2008;14:192–3.
6. Ertan S, Fresko I, Apaydin H, Ozekmekçi S, Yazici H. Extrapyramidal type rigidity in rheumatoid arthritis. Rheumatology 1999;38:627–30.
7. Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism col- laborative initiative. Arthritis Rheum 2010; (9):2569-81.
8. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clin- ico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181–4.

9. Perry VH. Contribution of systemic inflammation to chron- ic neurodegeneration. Acta Neuropathol 2010;120(3):277- 86. 10. Tansey MG, McCoy MK, Frank-Cannon TC. Neuroinflammatory mechanisms in Parkinson's disease: Potential environmental triggers, pathways, and tar- gets for early therapeutic intervention. Exp Neurol 2007;208:1–25.
10. Kones R. Parkinson's disease: mitochondrial molecular pathology, inflammation, statins, and therapeutic neuro- protective nutrition. Nutr Clin Pract 2010;25(4):371-89.
11. Becker C, Jick SS, Meier CR. NSAID use and risk of Parkinson disease: a population based case-control study. Eur J Neurol 2011;18(11):1336-42.