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.
Department of Neurology, Medical School, University of São Paulo, São Paulo, SP, Brazil.
Luís Otávio Sales Ferreira
LO
Caboclo
Nancy
N
Huang
Guilherme Alves
GA
Lepski
José Antônio
JA
Livramento
Carlos Alberto
CA
Buchpiguel
Cláudia Sellitto
CS
Porto
Ricardo
R
Nitrini
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