Abstract
BackgroundParkinson’s disease is a degenerative brain disease related to the accumulation of an abnormally aggregated alpha-synuclein protein. A hypothesis was presumed that this protein will be transported retrogradely from the gastrointestinal tract ultimately leading to the disease. Various epidemiologic studies have shown conflicting results. This study reports the prevalence of appendectomy in Jordanian parkinsonian patients and compares it to controls seen at one major teaching hospital in Jordan. This is a retrospective study of 266 patients compared to a control group of 500 patients randomly selected from the hospital. The prevalence of appendectomy in the 2 groups was studied.ResultsThe rate of appendectomy in patients and controls was 26/266 (9.8%) and 27/500 (5.4%), respectively (relative risk 1.30, odds ratio 1.81, χ2, p = 0.026). Appendectomy in the patients was independent of gender (χ2, p = 0.297). Also, there was no difference in patients with and without appendectomy regarding their age, age at diagnosis of PD, and duration of use of levodopa (p = 0.827, 0.960, and 0.688, respectively, Student t test). The mean duration from appendectomy to the diagnosis of the disease varied widely 23 ± 18.7 years, range −12–59 years.ConclusionsAppendectomy occurred significantly more frequent in patients with Parkinson’s disease than in control. There was no difference regarding the age of onset of disease in the patients with and without appendectomy. Though the appendix in this study seems to have a protective role against the development of the disease, the relationship is quite complex requiring prospective in-depth evaluation.
Highlights
Parkinson’s disease is a degenerative brain disease related to the accumulation of an abnormally aggregated alpha-synuclein protein
The discovery of inherited cases of Parkinson’s disease (PD) in a minority of patients 5–15% [4] and the knowledge of the function of some of the dysfunctional or mutated genes with advanced histopathological techniques lead to the consideration of the pathogenesis related to the accumulation of misfolded protein in Lewy bodies which are considered the pathological marker of PD [3, 5,6,7]
Clinical interest for the relationship between appendectomy which is a frequent procedure typically performed in early adulthood [10] and the future development of PD has been reported in the last few years
Summary
Parkinson’s disease is a degenerative brain disease related to the accumulation of an abnormally aggregated alpha-synuclein protein. Many such clinical observations and studies have been published with variable conclusions ranging from preventive or delaying [15,16,17], neutral [18,19,20], to accelerating/increasing [21, 22] the risk of occurrence of PD in patients who underwent appendectomy in their early adulthood These conflicting findings may be interpreted as a possible protective, neutral, or pathological role of the appendix in the development of sporadic PD. This retrospective study investigated if patients with the clinical diagnosis of PD had a significantly different prevalence of appendectomy compared to a control group and if those PD patients with appendectomy differed from PD patients without appendectomy regarding the onset of their disease
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