Characterization of sporadic creutzfeldt-jakob disease and history of neurosurgery to identify potential iatrogenic cases

Tsuyoshi Hamaguchi, Kenji Sakai, Atsushi Kobayashi, Tetsuyuki Kitamoto, Ryusuke Ae, Yosikazu Nakamura, Nobuo Sanjo, Kimihito Arai, Mizuho Koide, Fumiaki Katada, Masafumi Harada, Hiroyuki Murai, Shigeo Murayama, Tadashi Tsukamoto, Hidehiro Mizusawa, Masahito Yamada

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1140-1146
Number of pages7
JournalEmerging Infectious Diseases
Volume26
Issue number6
DOIs
Publication statusPublished - 2020 Jun

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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