Creutzfeldt-Jakob disease in United Kingdom patients treated with human pituitary growth hormone.
OBJECTIVE
To investigate risk factors for Creutzfeldt-Jakob disease (CJD) in patients in the United Kingdom treated with human pituitary growth hormone (hGH).


METHODS
Incidence rates of CJD, based on person-year denominators, were assessed in a cohort of 1,848 patients treated with hGH in the United Kingdom from 1959 through 1985 and followed to the end of 2000.


RESULTS
CJD developed in 38 patients. Risk of CJD was significantly increased by treatment with hGH prepared by the Wilhelmi method of extraction from human pituitaries. Risk was further raised if this treatment was administered at ages 8 to 10 years. The peak risk of CJD was estimated to occur 20 years after first exposure, and the estimated lifetime cumulative risk of CJD in Wilhelmi-treated patients was 4.5%.


CONCLUSIONS
Size-exclusion chromatography, used in non-Wilhelmi preparation methods, may prevent CJD infection. Susceptibility to CJD may vary with age, and susceptibility may be present in only a few percent of the population.
D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications; D005591:Chemical Fractionation / Q000379:methods; D002648:Child; D002850:Chromatography, Gel; D015331:Cohort Studies; D007562:Creutzfeldt-Jakob Syndrome / Q000150:complications / Q000453:epidemiology / Q000235:genetics / Q000635:transmission*; D016208:Databases, Factual; D004393:Dwarfism, Pituitary / Q000150:complications / Q000188:drug therapy; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000302:isolation & purification; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology; D015994:Incidence; D008297:Male; D010902:Pituitary Gland / Q000737:chemistry*; D011328:Prions / Q000235:genetics / Q000302:isolation & purification; D016016:Proportional Hazards Models; D012306:Risk; D013997:Time Factors; D014020:Tissue Extracts / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
D011328:Prions; D014020:Tissue Extracts; D019382:Human Growth Hormone