title: Phenotype in patients with Gaucher disease and Parkinson disease.
abstract: BACKGROUND
  Previous reports have shown an increased risk for Parkinson disease (PD) among type 1 Gaucher disease (GD) patients. However, the number of the reported cases of GD/PD is small and it is unknown whether certain GD phenotypes are associated with an increased PD risk.
  
  
  OBJECTIVE
  To present GD and PD characteristics of adults affected by both diseases from a large Israeli GD clinic, and assess whether certain GD characteristics are associated with a higher risk for PD.
  
  
  METHODS
  Medical files of patients >18years between 1990 and 2010 were reviewed for PD signs or symptoms. Available patients with PD underwent an additional neurological examination. Demographic and GD characteristics were compared between GD patients with and without PD using t-test and Fisher exact. Kaplan-Meier survival curves were used to estimate age-specific risk for PD among males and females. Age-specific risk for PD was compared between males and females using Cox Hazard ratio model.
  
  
  RESULTS
  510 type 1 GD adults (233 males; 45.7%), were evaluated. 11 PD patients were identified (2.2%). Among those with GD/PD cognitive impairment was common (7/11). Two patients underwent successful deep brain stimulation (DBS). PD diagnosis was associated with male gender (81.8% versus 44.9% male, p=0.027) and older age (mean age, PD=62.8, non-PD=47.1, p=0.004). GD phenotype and severity did not differ between the two groups, including mean Zimran Severity Score index (7.7 versus 8.3), percent splenectomized (15.8% versus 27.3%), history of avascular necrosis (13.0% versus 27.3%) and percent ever treated with enzyme replacement (49.4% versus 45.5%).
  
  
  CONCLUSIONS
  Male gender and older age are risk factors for PD among GD patients, but GD severity is not associated with increased risk for PD. Further research is required to assess which GD patients are at a higher risk for PD, and why.
authors.affiliation: Gaucher Clinic, Shaare Zedek Medical Center, Jerusalem, affiliated with the Hebrew University - Hadassah Medical School, Ein Karem, Israel.
authors.forename: Eli Ben
authors.initials: EB
authors.lastname: Chetrit
authors.forename: Roy N
authors.initials: RN
authors.lastname: Alcalay
authors.forename: Bettina
authors.initials: B
authors.lastname: Steiner-Birmanns
authors.forename: Gheona
authors.initials: G
authors.lastname: Altarescu
authors.forename: Mici
authors.initials: M
authors.lastname: Phillips
authors.forename: Deborah
authors.initials: D
authors.lastname: Elstein
authors.forename: Ari
authors.initials: A
authors.lastname: Zimran
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005776:Gaucher Disease / Q000150:complications* / Q000235:genetics / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000235:genetics / Q000401:mortality; D010641:Phenotype; D012737:Sex Factors; D055815:Young Adult