title: Successful twin pregnancy in a patient with parkin-associated autosomal recessive juvenile parkinsonism.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Serikawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Shimohata
authors.forename: Mami
authors.initials: M
authors.lastname: Akashi
authors.forename: Akio
authors.initials: A
authors.lastname: Yokoseki
authors.forename: Miwa
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Arika
authors.initials: A
authors.lastname: Hasegawa
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Haino
authors.forename: Ryoko
authors.initials: R
authors.lastname: Koike
authors.forename: Koichi
authors.initials: K
authors.lastname: Takakuwa
authors.forename: Keiko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nishizawa
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009154:Mutation; D020734:Parkinsonian Disorders / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics; D011256:Pregnancy Outcome; D014427:Twins; D044767:Ubiquitin-Protein Ligases / Q000235:genetics
chemical_list: D044767:Ubiquitin-Protein Ligases; C111567:parkin protein