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CASE REPORT
Year : 2020  |  Volume : 68  |  Issue : 2  |  Page : 481--482

Parkinsonism with Newly Diagnosed Flare-up Rheumatoid Arthritis Mimicking Progressive Supranuclear Palsy

Kuo-Wei Lee1, Ching-Fang Chien1, Meng-Ni Wu2, Chiou-Lian Lai2, Li-Min Liou2 
1 Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2 Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of Neurology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence Address:
Li-Min Liou
Kaohsiung Municipal Siaogang Hospital No.482, Shanming Rd., Siaogang Dist., Kaohsiung City 812
Taiwan

In order to make a correct diagnosis of idiopathic Parkinson's disease (PD), it is essential to exclude atypical parkinsonian features, such as early dementia, fall, and autonomic dysfunction. Rheumatoid arthritis (RA), which is a systemic inflammatory disorder, although most patients present in a polyarticular manner. Still some may also present with extra-articular involvement including skin, lung, heart, and the central or peripheral nervous systems. A possible pathogenetic link between RA and PD are proposed. However, the coexistence of RA and progressive supranuclear palsy (PSP) is rarely reported. Here, we report a parkinsonian patient with a newly diagnosed flare-up RA presenting with early falls, postural instability and supra-nuclear gaze palsy, which suggestive of clinically probable PSP. Furthermore, the parkinsonian features respond to anti-rheumatic agents, but not levodopa. Finally, the patient looks like a clinical possible PD. In summary, Parkinsonian patient with newly diagnosed flare-up RA can present with clinically probable PSP. Unbearably painful limb contracture is a clue of the coexistence of RA. Both typical and atypical parkinsonian features respond dramatically to anti-rheumatic medication, but not levodopa.


How to cite this article:
Lee KW, Chien CF, Wu MN, Lai CL, Liou LM. Parkinsonism with Newly Diagnosed Flare-up Rheumatoid Arthritis Mimicking Progressive Supranuclear Palsy.Neurol India 2020;68:481-482


How to cite this URL:
Lee KW, Chien CF, Wu MN, Lai CL, Liou LM. Parkinsonism with Newly Diagnosed Flare-up Rheumatoid Arthritis Mimicking Progressive Supranuclear Palsy. Neurol India [serial online] 2020 [cited 2022 Jun 25 ];68:481-482
Available from: https://www.neurologyindia.com/article.asp?issn=0028-3886;year=2020;volume=68;issue=2;spage=481;epage=482;aulast=Lee;type=0