Ann Arthritis Clin Rheumatol | Volume 2, Issue 1 | Case Report | Open Access

A Patient with Ankylosing Spondylitis, Parkinson’s Diseaseand Seminoma Testis - Three Different Diagnoses or One Disease with Multiple Faces

Milena Kirilova and Lyubomir Marinchev*

Clinic for Rheumatology, University Hospital Sofiamed, Bulgaria

*Correspondance to: Lyubomir Marinchev 

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Abstract

Introduction: Ankylosing Spondylitis (AS), Parkinson Disease (PD) and Seminoma testis are three different diseases with their own characteristics. The contemporary treatment with biological diseasemodifying antirheumatic drugs (bDMARDs) of AS, sometimes can trigger neoplastic processes. Whether there is a relationship between AS and Parkinson disease, or the latter is triggered by biological treatment of AS, similarly to causing cancers, is not well known. Case
Presentation: We report a case of 43 years old man with proven Ankylosing spondylitis, later presented with Parkinson disease and seminoma testis. The patient was diagnosed 6 years ago with AS according to modified New York criteria. Prior to hospitalization he was treated with NSAIDs, parenteral corticosteroids and myorelaxants without any results. One year later he started a therapy with Adalimumab with very good effect lasting one year, thereafter – with Golimumab, because of decreasing of Adalimumab efficacy and disease flare. Around three months after Golimumab therapy, he became stiffed, with slow movements and tremor. The patient was diagnosed as having Parkinson disease and the biologic was stopped as a suspicious for the neurological disorder. One year later he was diagnosed with seminoma and had surgical treatment. When admitted to the Rheumatology department he had a flare of AS with increased inflammatory response, sacroiliitis 3rd degree on X-ray (Figure 1) and extremely stiffness and back pain.
Conclusion: Ankylosing Spondylitis is an autoimmune inflammatory joint disease, disabling when not treated adequately. Sometimes it is complicated by itself or by the treatment especially biologics. It is well known that biologics can cause neoplastic processes in the time of treatment, but whether they can lead to drug-induced Parkinson disease, or no not, is not elucidated.

Citation:

Kirilova M, Marinchev L. A Patient with Ankylosing Spondylitis, Parkinson’s Disease and Seminoma Testis - Three Different Diagnoses or One Disease with Multiple Faces. Ann Arthritis Clin Rheumatol. 2019; 2(1): 1010.

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