title: Estrogen intake and copper depositions: implications for Alzheimer's disease?
abstract: We present a patient with chronic postmenopausal estrogen intake with presence of Kayser-Fleischer ring in the cornea and Alzheimer's disease and discuss the pathophysiological mechanisms of estrogen intake and copper accumulation in various tissues, including the central nervous system. Sonography was compatible with copper accumulation in the basal ganglia, but the patient showed no clinical signs of Wilson's disease. Magnetic resonance imaging and positron emission tomography revealed a typical pattern for Alzheimer's disease. We propose increased copper levels as a direct effect of estrogen intake due to an augmented ATP7A-mRNA in the intestine. Moreover, we discuss the impact of elevated free serum copper on accompanying Alzheimer's disease, knowing that copper plays a crucial role in the formation of amyloid plaques and tau aggregation. This might offer a partial explanation for the observation that postmenopausal estrogen therapy is associated with a higher risk of mild cognitive impairment and Alzheimer's disease.
authors: Department of Neurology, University Medical Center Freiburg, Germany.
authors: Florian
authors: F
authors: Amtage
authors: Department of University Eye Hospital Freiburg, Freiburg, Germany.
authors: Dzelila
authors: D
authors: Birnbaum
authors: Department of University Eye Hospital Freiburg, Freiburg, Germany.
authors: Thomas
authors: T
authors: Reinhard
authors: Department of Neurology, University Medical Center Freiburg, Germany.
authors: Wolf-Dirk
authors: WD
authors: Niesen
authors: Department of Neurology, University Medical Center Freiburg, Germany.
authors: Cornelius
authors: C
authors: Weiller
authors: Department of Neuroradiology, University Medical Center Freiburg, Germany.
authors: Irina
authors: I
authors: Mader
authors: Department of Nuclear Medicine, University Medical Center Freiburg, Germany.
authors: Philipp T
authors: PT
authors: Meyer
authors: Department of Neurology, University Medical Center Freiburg, Germany.
authors: Michel
authors: M
authors: Rijntjes
keywords: Alzheimer's disease; Ceruloplasmin; Copper; Estrogen; [11C]PIB PET