Hypothyroidism and Parkinson's disease and the issue of diagnostic confusion

García‐Moreno, José Manuel; Chacón-Peña, José

doi:10.1002/mds.10475

Cited by 19 publications

(11 citation statements)

References 10 publications

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“…Based on this didactic case and as pointed out by other authors, 2 – 4 thyroid function assessment should not be overlooked in patients with PD who experience rapid aggravation of parkinsonism, encephalopathy, and myoclonus. Since hypothyroidism can be managed with appropriate medication, it should be included in the list of differential diagnoses of unusual aggravation of parkinsonism and symptoms that are not typical for PD, especially when the patient has underlying thyroid disease.…”

Section: Discussionsupporting

confidence: 52%

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Hypothyroidism-induced Reversible Encephalopathy as a Cause of Aggravation of Parkinsonism and Myoclonus in Parkinson’s Disease

Ehm

Kim

Jeon

2017

Tremor and Other Hyperkinetic Movements

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Section: Discussionsupporting

confidence: 52%

“…There is limited information on patients with aggravated parkinsonism due to hypothyroidism 2 , 3 or hyperthyroidism. 4 , 5 The accompanied encephalopathy and myoclonus, which were reversed by levothyroxine therapy, have not yet been reported in patients with PD and hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism-induced Reversible Encephalopathy as a Cause of Aggravation of Parkinsonism and Myoclonus in Parkinson’s Disease

Ehm

Kim

Jeon

2017

Tremor and Other Hyperkinetic Movements

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“…The development of hypothyroidism in the setting of Parkinson's disease may be mistaken for worsening parkinsonism, but the symptoms can improve with thyroid hormone replacement. 1 Conversely, hyperthyroidism may mimic the weight loss or increased sweating seen with Parkinson's disease or may exaggerate parkinsonian tremor, and improvement occurs with antithyroid treatment. 2…”

Section: Thyroid Diseasementioning

confidence: 99%

Movement Disorders Caused by Medical Disease

2009

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Movement disorders often occur in the context of medical illness, whether as the presenting sign of the illness, as a related feature of the underlying disease process, or as a complication of treatment. Early recognition of an underlying medical cause for movement disorders is essential because the treatment and prognosis differ significantly depending on the underlying pathophysiology. Parkinsonism, nonparkinsonian tremor, dystonia, and chorea have a wide variety of etiologies, requiring a careful medical history in the evaluation of new-onset movement disorders. The spectrum of medical diseases associated with these four syndromes is reviewed in this article.

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“…In particular, our predictive model has high performance in distinguishing GD and Parkinson's disease (PD). The two diseases share highly similar symptoms such as rigidity, hypokinesia, facial hypomimia, and voice abnormalities, causing diagnostic confusion in clinical practices, especially for elders suffering GD and/or PD [4,25,26]. Five GD-enriched MAGs related to genera Coprobacillus and Streptococcus exhibited excellent speci city.…”

Section: Discussionmentioning

confidence: 99%

Ecological and Evolutionary Alterations in Graves’ Disease Gut Microbiome Reveal Specific Diagnostic Biomarkers

Zhu¹,

Hou²,

Huang³

et al. 2020

Preprint

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Background: Graves’ Disease (GD) is the most common organ-specific autoimmune disease and has been linked in small pilot studies to taxonomic markers within the gut microbiome. However, the small sample size and limited resolution of the 16S rRNA amplicon sequencing technology limited the universality and significance of these studies. Larger cohorts and integration of different levels of analysis from high-resolution shotgun metagenomics data were therefore needed to explore the GD patients’ alteration in gut microbial taxonomy, genes, pathways and functions, metabolites, and mutational spectra, to establish robust microbial biomarkers at these levels for GD diagnosis.Results: Here, we studied 162 gut microbiomes of mild and severe Graves’ disease (GD) patients and healthy controls. Shotgun metagenomic sequencing and inferred metabolomics were applied to describe the intestinal microbial characteristics and microbial mutations of GD patients. Then, combined biomarkers were identified from machine learning. Finally, we performed a meta-analysis to confirm the specificity of these biomarkers across different metabolic and autoimmune diseases. Taxonomic and functional analyses based on metagenome-assembled genomes (MAGs) and MAG-annotated genes, together with predicted metabolic functions and metabolite profiles, revealed a bipartite co-occurrence network of MAGs, genes and clinical indexes separating healthy from GD subjects. A supervised classification model identified a combination of biomarkers including microbial species, MAGs, genes and SNPs, with predictive power superior to models from any single biomarker type (AUC=0.98). Global, cross-disease meta-analysis of gut microbiomes revealed high specificity of these GD biomarkers, notably discriminating against Parkinson’s Disease, and suggesting that non-invasive stool-based diagnostics will be useful for these diseases.Conclusions: This work extended our understanding of the microbial ecology and evolution of GD pathogenesis, and developed a useful predictive model for GD diagnosis based on intestinal microbial biomarkers.

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Hypothyroidism and Parkinson's disease and the issue of diagnostic confusion

Abstract: Development of hypothyroidism may easily be overlooked when occurring together with Parkinson's disease (PD), because many of the symptoms of the two disorders are similar. We report on a case of a woman suffering from both PD and hypothyroidism and review the literature on the subject.

Cited by 19 publications

References 10 publications

Hypothyroidism-induced Reversible Encephalopathy as a Cause of Aggravation of Parkinsonism and Myoclonus in Parkinson’s Disease

Hypothyroidism-induced Reversible Encephalopathy as a Cause of Aggravation of Parkinsonism and Myoclonus in Parkinson’s Disease

Movement Disorders Caused by Medical Disease

Ecological and Evolutionary Alterations in Graves’ Disease Gut Microbiome Reveal Specific Diagnostic Biomarkers

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