PARKINSON'S DISEASE ACCOMPANIED BY PRIMARY BILIARY CIRRHOSIS: A CASE REPORT.

Correspondence to: Maryam Poursadeghfard, MD, Clinical Neurology Research Center, Department of Neurology, Motahari Clinic, Nemazee Sq, Shiraz, Iran ( poursadegh@sums.ac.ir or poursadra@ gmail.com ). Parkinson’s disease (PD) is a disorder with multiple motor manifestations including resting tremor, bradykinesia, akinesia, rigidity, and postural instability due to loss of dopaminergic neurons in substantia nigra ( Zaltieri et al., 2015 ). The prevalence of PD is estimated to be about 1% ( Ryan, Hoek, Fon, & Wade-Martins, 2015 ). Ten percent of all Parkinson’s cases are hereditary and lead to early onset of the disease ( Spatola & Wider, 2014 ). Many investigators believe that PD arises from the interaction between genetic and environmental factors ( Pringsheim, Jette, Frolkis, & Steeves, 2014 ). Thus, it can lead to different molecular mechanisms related to the neurodegenerative process, probably by inducing mitochondrial impairment from deposition of α -synuclein ( Zaltieri et al., 2015 ). Primary biliary cirrhosis (PBC) is a chronic and slow progressive liver disease suspected to be due to an autoimmune cause because of its strong association with specific autoantibodies (antimitochondrial and antigp210 antibodies) ( Corpechot, Chretien, Chazouilleres, & Poupon, 2010 ). This disease can lead to liver cirrhosis ( Newton et al., 2007 ). The most prevalent symptom is fatigue, which is unrelated to the disease severity ( Huet, Deslauriers, Tran, Faucher, & Charbonneau, 2000 ) and can be attributed to a central mechanism ( Newton et al., 2007 ). Primary biliary cirrhosis is more prevalent in females and is believed to have a correlation with other autoimmune illnesses such as rheumatoid arthritis, systemic lupus erythematous, and Graves’ disease. Some genetic and environmental factors are assumed to contribute to the development of PBC ( Corpechot et al., 2010 ). PARKINSON’S DISEASE ACCOMPANIED BY PRIMARY BILIARY CIRRHOSIS: A CASE REPORT