Creutzfeldt-Jakob disease following corneal transplantation.
OBJECTIVE
To report a case of possible iatrogenic Creutzfeldt-Jakob many years following penetrating keratoplasty.


METHODS
Observational case report.


METHODS
We reviewed the patient's chart, available literature on Creutzfeldt-Jakob disease, and current recommendations from the Eye Bank of America Association.


RESULTS
An 80-year-old woman with a history of granular dystrophy underwent penetrating keratoplasty in 1978 (OS) and 1987 (OD) for decreased visual acuity. In early July 2002 the patient developed rapidly progressive dementia. Attempts were made to procure information regarding the corneal donors. No information was available. The patient expired slightly less than 1 month after her onset of symptoms. Review of the EBAA medical standards before October 2002 reveal that donor records were to be kept for a minimum of 10 years.


CONCLUSIONS
Creutzfeldt-Jakob disease occurred 15 to 24 years after bilateral penetrating keratoplasy, but donor-to-host transmission was uncertain because no information on the corneal donor could be retrieved. Eye-bank records should be kept indefinitely because CJD may occur decades after iatrogenic exposure.
Hammersmith
Kristin M
KM
Cornea Service, Wills Eye Hospital, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Cohen
Elisabeth J
EJ
Rapuano
Christopher J
CJ
Laibson
Peter R
PR
D000368:Aged; D000369:Aged, 80 and over; D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000635:transmission; D018562:Disease Transmission, Infectious; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D012307:Risk Factors; D014019:Tissue Donors