A 44-year-old man with a history of unexplained sensory hearing loss, cataracts, dyslipidemia, and osteoarthritis presented with progressive parkinsonism and poor levodopa response. Neurological examination showed a masked face as well as symmetric slowness and stiffness. Genetic testing confirmed a variant in the DJ-1 gene (PARK7), which is a form of genetic Parkinson disease.
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