Triple Crown: A Single Autopsy Case with Alzheimer’s Disease, Parkinson’s Disease, and Progressive Supranuclear Palsy

Abstract Introduction/Objective Neurodegenerative diseases such as Alzheimer’s Disease(AD), Idiopathic Parkinson’s disease (PD), and Progressive Supranuclear Palsy (PSP), manifest with progressive cognitive and motor deterioration. While each condition traditionally presents distinct clinical features, overlapping symptoms among them make antemortem clinical diagnose less accurate. Concomitant proteinopathies are frequent among neurodegenerative diseases. Here, we report a single autopsy case demonstrating the simultaneous presence of PSP, PD and AD. Methods/Case Report A 70- year- old male, with dementia and a familial history of progressive supranuclear palsy in his brother, underwent autopsy due to concern for progressive supranuclear palsy. The histopathological examination revealed the presence of “ C” age- related plaque score providing definite diagnosis of Alzheimer’s disease. Immunohistochemistry studies on brain sections revealed the presence of Tau positive globose tangles and neurites indicating progressive supranuclear palsy. Furthermore, alpha-synuclein positivity was observed for Lewy bodies and Lewy neurites, confirming idiopathic Parkinson’s disease. Results (if a Case Study enter NA) NA Conclusion While coexisting neurodegenerative diseases with different proteinopathies have been well documented, this case represents the first report providing pathological confirmation of the simultaneous presence of Alzheimer’s Disease, Parkinson’s Disease, and progressive supranuclear palsy in a single patient. These unique findings underscore the complexity of neurodegenerative processes and highlights the importance of comprehensive diagnostic evaluation in patients presenting with overlapping clinical symptoms. These findings hold significant potential to contribute further in the field.