Iatrogenic Creutzfeldt-Jakob disease following human growth hormone therapy: case report.
We report the case of a 41-year-old man with iatrogenic Creutzfeldt-Jakob disease (CJD) acquired after the use of growth hormone (GH) obtained from a number of pituitary glands sourced from autopsy material. The incubation period of the disease (from the midpoint of treatment to the onset of clinical symptoms) was rather long (28 years). Besides the remarkable cerebellar and mental signs, the patient exhibited sleep disturbance (excessive somnolence) from the onset of the symptoms, with striking alteration of the sleep architecture documented by polysomnography. 14-3-3 protein was detected in the CSF, and MRI revealed increased signal intensity bilaterally in the striatum, being most evident in diffusion-weighted (DW-MRI) sequences. This is the second case of iatrogenic CJD associated with the use of GH reported in Brazil.
Caboclo
Luís Otávio Sales Ferreira
LO
Department of Neurology, Medical School, University of São Paulo, São Paulo, SP, Brazil.
Huang
Nancy
N
Lepski
Guilherme Alves
GA
Livramento
José Antônio
JA
Buchpiguel
Carlos Alberto
CA
Porto
Cláudia Sellitto
CS
Nitrini
Ricardo
R
D048948:14-3-3 Proteins; D000328:Adult; D015153:Blotting, Western; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis*; D007562:Creutzfeldt-Jakob Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000209:etiology*; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D008279:Magnetic Resonance Imaging; D008297:Male; D014446:Tyrosine 3-Monooxygenase / Q000134:cerebrospinal fluid
D048948:14-3-3 Proteins; D002556:Cerebrospinal Fluid Proteins; D019382:Human Growth Hormone; D014446:Tyrosine 3-Monooxygenase