The risk of iatrogenic Creutzfeldt-Jakob disease through medical and surgical procedures: Symposium: Prion diseases - Updated

Tsuyoshi Hamaguchi, Moeko Noguchi-Shinohara, Ichiro Nozaki, Yosikazu Nakamura, Takeshi Sato, Tetsuyuki Kitamoto, Hidehiro Mizusawa, Masahito Yamada

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)

Abstract

There have been more than 400 patients who contracted Creutzfeldt-Jakob disease (CJD) via a medical procedure, that is, through the use of neurosurgical instruments, intracerebral electroencephalographic electrodes (EEG), human pituitary hormone, dura mater grafts, corneal transplant, and blood transfusion. The number of new patients with iatrogenic CJD has decreased; however, cases of variant CJD that was transmitted via blood transfusion have been reported since 2004. Clearly, iatrogenic transmission of CJD remains a serious problem. Recently, we investigated medical procedures (any surgery, neurosurgery, ophthalmic surgery, and blood transfusion) performed on patients registered by the CJD Surveillance Committee in Japan during a recent 9-year period. In a case-control study comprising 753 sporadic CJD (sCJD) patients and 210 control subjects, we found no evidence that prion disease was transmitted via the investigated medical procedures before onset of sCJD. In a review of previously reported case-control studies, blood transfusion was never shown to be a significant risk factor for CJD; our study yielded the same result. Some case-control studies reported that surgery was a significant risk factor for sCJD. However, when surgical procedures were categorized by type of surgery, the results were conflicting, which suggests that there is little possibility of prion transmission via surgical procedures. In our study, 4.5% of sCJD patients underwent surgery after onset of sCJD, including neurosurgeries in 0.8% and ophthalmic surgeries in 1.9%. The fact that some patients underwent surgery, including neurosurgery, even after the onset of sCJD indicates that we cannot exclude the possibility of prion transmission via medical procedures. We must remain vigilant against prion diseases to reduce the risk of iatrogenesis.

Original languageEnglish
Pages (from-to)625-631
Number of pages7
JournalNeuropathology
Volume29
Issue number5
DOIs
Publication statusPublished - 2009 Oct

Keywords

  • Blood transfusion
  • Creutzfeldt-Jakob disease
  • Medical procedure
  • Neurosurgery
  • Ophthalmic surgery
  • Prion
  • Surgery

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology

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