Effect of percutaneous endoscopic gastrojejunostomy tube placement on levodopa pharmacokinetics
- 16 Downloads
Most patients with Parkinson’s disease (PD) experience motor fluctuations, including the wearing-off phenomenon, in the advanced stage. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG) via percutaneous endoscopic gastrojejunostomy (PEG-J) helps maintain adequate plasma concentrations of levodopa and ameliorates the motor fluctuations in patients with advanced PD. A recent study reported an effective long-term maintenance of the motor symptoms in patients with PD who received LCIG treatment . However, complications related to the tube and pump are common, occasionally necessitating withdrawal of the LCIG treatment .
We present the case of a 71-year-old female with PD, who was the subject of a previous report on the relationship between a cascade stomach, which is a functional deformity of stomach with biloculation of the gastric cavity, and the levodopa pharmacokinetics . The patient exhibited motor fluctuations, such as wearing-off phenomenon and...
NM and HY were involved in conception and designed the study. NM was involved in acquisition and analysis of the data. NM drafted the manuscript and HY, MNagai, MNomoto critically revised the manuscript. All authors gave the final approval of the manuscript to be published.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical compliance statement
The patient provided informed consent for publication. The authors confirm that the approval of an institutional review board was not required for this work. We confirm that we have read the Journal’s policy on ethical publication and affirm that this work is consistent with those guidelines.
Informed consent was obtained from the participant included in the study.
- 1.Fernandez HH, Boyd JT, Fung VSC, Lew MF, Rodriguez RL, Slevin JT, Standaert DG, Zadikoff C, Vanagunas AD, Chatamra K, Eaton S, Facheris MF, Hall C, Robieson WZ, Benesh J, Espay AJ (2018) Long-term safety and efficacy of levodopa-carbidopa intestinal gel in advanced Parkinson’s disease. Mov Disord 33(6):928–936. https://doi.org/10.1002/mds.27338 CrossRefGoogle Scholar
- 2.Fernandez HH, Standaert DG, Hauser RA, Lang AE, Fung VS, Klostermann F, Lew MF, Odin P, Steiger M, Yakupov EZ, Chouinard S, Suchowersky O, Dubow J, Hall CM, Chatamra K, Robieson WZ, Benesh JA, Espay AJ (2015) Levodopa-carbidopa intestinal gel in advanced Parkinson’s disease: final 12-month, open-label results. Mov Disord 30(4):500–509. https://doi.org/10.1002/mds.26123 CrossRefGoogle Scholar
- 5.Antonini A, Yegin A, Preda C, Bergmann L, Poewe W, GLORIA study investigators and coordinators (2015) Global long-term study on motor and non-motor symptoms and safety of levodopa-carbidopa intestinal gel in routine care of advanced Parkinson’s disease patients; 12-month interim outcomes. Parkinsonism Relat Disord 21(3):231–235. https://doi.org/10.1016/j.parkreldis.2014.12.012 CrossRefGoogle Scholar