Successful twin pregnancy in a patient with parkin-associated autosomal recessive juvenile parkinsonism
1 Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan
2 Department of Neurology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan
3 Department Neurology, Nishi-Niigata Chuo National Hospital, Niigata 950-2085, Japan
4 Department of Neurology, Kanazawa Medical University, Kanazawa 920-0293, Japan
BMC Neurology 2011, 11:72 doi:10.1186/1471-2377-11-72Published: 17 June 2011
Pregnancy in patients with Parkinson disease is a rare occurrence. To the best of our knowledge, the effect of pregnancy as well as treatment in genetically confirmed autosomal recessive juvenile parkinsonism (ARJP) has never been reported. Here, we report the first case of pregnancy in a patient with ARJP associated with a parkin gene mutation, ARJP/PARK2.
A 27-year-old woman with ARJP/PARK2 was diagnosed as having a spontaneous dichorionic/diamniotic twin pregnancy. Exacerbation of motor disability was noted between ovulation and menstruation before pregnancy as well as during late pregnancy, suggesting that her parkinsonism might have been influenced by fluctuations in the levels of endogenous sex hormones. During the organogenesis period, she was only treated with levodopa/carbidopa, although she continued to receive inpatient hospital care for assistance in the activities of daily living. After the organogenesis period, she was administered sufficient amounts of antiparkinsonian drugs. She delivered healthy male twins, and psychomotor development of both the babies was normal at the age of 2 years.
Pregnancy may worsen the symptoms of ARJP/PARK2, although appropriate treatments with antiparkinsonian drugs and adequate assistance in the activities of daily living might enable successful pregnancy and birth of healthy children.