TY - JOUR
T1 - Characterization of sporadic creutzfeldt-jakob disease and history of neurosurgery to identify potential iatrogenic cases
AU - Hamaguchi, Tsuyoshi
AU - Sakai, Kenji
AU - Kobayashi, Atsushi
AU - Kitamoto, Tetsuyuki
AU - Ae, Ryusuke
AU - Nakamura, Yosikazu
AU - Sanjo, Nobuo
AU - Arai, Kimihito
AU - Koide, Mizuho
AU - Katada, Fumiaki
AU - Harada, Masafumi
AU - Murai, Hiroyuki
AU - Murayama, Shigeo
AU - Tsukamoto, Tadashi
AU - Mizusawa, Hidehiro
AU - Yamada, Masahito
N1 - Funding Information:
This work was supported by a grant-in-aid from the Research Committee of Prion Disease and Slow Virus Infection, the Ministry of Health, Labour and Welfare of Japan to T.H., R.A., H.M., and M.Y.; a grant-in-aid from the Research Committee of Surveillance and Infection Control of Prion Disease, the Ministry of Health, Labour, and Welfare of Japan to T.K., Y.N., N.S., T.T., H.M., and M.Y.; and a grant-in-aid from the Research Committee of Molecular Pathogenesis and Therapies for Prion Disease and Slow Virus Infection, Agency for Medical Research and Development to T.H., A.K., H.M., and M.Y.
Publisher Copyright:
© 2020 Centers for Disease Control and Prevention (CDC). All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - We previously reported a phenotype of Creutzfeldt-Jakob disease (CJD), CJD-MMiK, that could help identify iatrogenic CJD. To find cases mimicking CJD-MMiK, we investigated clinical features and pathology of 1,155 patients with diagnosed sporadic CJD or unclassified CJD with and without history of neurosurgery. Patients with history of neurosurgery more frequently had an absence of periodic sharp-wave complexes on electroencephalogram than patients without a history of neurosurgery. Among 27 patients with history of neurosurgery, 5 had no periodic sharp-wave complexes on electroencephalogram. We confirmed 1 case of CJD-MMiK and suspected another. Both had methionine homozygosity at codon 129 of the prion protein gene and hyperintensity lesions in the thalamus on magnetic resonance images of the brain, which might be a clinical marker of CJD-MMiK. A subgroup with a history of neurosurgery and clinical features mimicking dura mater graft-associated CJD might have been infected during neurosurgery and had symptoms develop after many years.
AB - We previously reported a phenotype of Creutzfeldt-Jakob disease (CJD), CJD-MMiK, that could help identify iatrogenic CJD. To find cases mimicking CJD-MMiK, we investigated clinical features and pathology of 1,155 patients with diagnosed sporadic CJD or unclassified CJD with and without history of neurosurgery. Patients with history of neurosurgery more frequently had an absence of periodic sharp-wave complexes on electroencephalogram than patients without a history of neurosurgery. Among 27 patients with history of neurosurgery, 5 had no periodic sharp-wave complexes on electroencephalogram. We confirmed 1 case of CJD-MMiK and suspected another. Both had methionine homozygosity at codon 129 of the prion protein gene and hyperintensity lesions in the thalamus on magnetic resonance images of the brain, which might be a clinical marker of CJD-MMiK. A subgroup with a history of neurosurgery and clinical features mimicking dura mater graft-associated CJD might have been infected during neurosurgery and had symptoms develop after many years.
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U2 - 10.3201/EID2606.181969
DO - 10.3201/EID2606.181969
M3 - Article
C2 - 32442393
AN - SCOPUS:85085537661
VL - 26
SP - 1140
EP - 1146
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
SN - 1080-6040
IS - 6
ER -
