Creutzfeldt–Jakob disease via dural and corneal transplants

A review of all published cases of iatrogenic Creutzfeldt–Jakob disease (CJD) via dural ( N=71) and corneal ( N=4) transplants is given. All but three of the dural cases were obviously due to a commercial product recalled in 1996. Two of the corneal grafts were taken from patients who had died of sp...

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Bibliographic Details
Published in:Journal of the neurological sciences 1998-10, Vol.160 (2), p.128-139
Main Authors: Lang, C.J.G, Heckmann, J.G, Neundörfer, B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ataxia - etiology
Biological and medical sciences
Child
Cornea
Corneal Transplantation - adverse effects
corneal transplantations
Creutzfeldt-Jakob Syndrome - diagnosis
Creutzfeldt-Jakob Syndrome - epidemiology
Creutzfeldt-Jakob Syndrome - etiology
Creutzfeldt-Jakob Syndrome - transmission
Creutzfeldt–Jakob disease
Dementia
dura
Dura mater
Dura Mater - transplantation
dural transplantations
Dysarthria - etiology
eye transplantations
Female
Human Growth Hormone - adverse effects
Human viral diseases
Humans
Iatrogenic Disease - epidemiology
Iatrogenic transmission
Infant
Infectious diseases
Male
Medical sciences
Middle Aged
Myoclonus - etiology
Transplantation
Viral diseases
Viral diseases of the nervous system
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Summary:A review of all published cases of iatrogenic Creutzfeldt–Jakob disease (CJD) via dural ( N=71) and corneal ( N=4) transplants is given. All but three of the dural cases were obviously due to a commercial product recalled in 1996. Two of the corneal grafts were taken from patients who had died of sporadic CJD. These cases differed from CJD due to human growth hormone injections and the new variant. Instead, they were akin to sporadic cases, but memory loss, disorders of higher cerebral functions and extrapyramidal signs were fewer, while cerebellar abnormalities were more frequent. Progressive dysarthria and gait disorder/gait ataxia were prominent signs during the early stages, myocloni the most salient feature later. A nonperiodic EEG did not contradict the diagnosis. Using current diagnostic criteria the disease was underdiagnosed ante mortem. Utmost care is needed in selecting, harvesting and handling dural and corneal grafts to avoid inadvertent transmission of CJD.
ISSN:0022-510X
1878-5883
DOI:10.1016/S0022-510X(98)00226-3