NR AATT
AU Arya,S.C.
TI Diagnosis of new variant Creutzfeldt-Jakob disease by tonsil biopsy
QU Lancet 1997 May 3; 349(9061): 1322-3
KZ Lancet. 1997 Jan 11;349(9045):99-100. PMID: 8996424
PT comment; letter
VT
Sir - Hill and colleagues' (Jan 11, p 99)[1] immunohistochemistry and western blot analysis on tonsillar tissue obtained at necropsy in a 35-year-old woman who had a diagnosis of new variant Creutzfeldt-Jakob disease (nvCJD) revealed abnormal replication of protease-resistant prion protein (PrP) in the tonsillar germinal centre. Apart from a tonsillar biopsy for an early clinical or preclinical diagnosis of CJD or nvCJD by immunohistochemistry and western blot analysis, it would be better to use aspirated core tissue from tonsils for these investigations. During bacteriological analysis of recurrent tonsillitis in 34 patients, Timon and colleagues[2] found that the qualitative and quantitative data from aspirated core tissue and excised tissue were similar. Furthermore, even in individuals who had early tonsillectomy lymphoid tissue could be localised by ultrasonography or computed tomography. Both techniques would guide the needle for aspiration of tonsillar tissue through the peroral route.
Cross-contamination or iatrogenic transmission of abnormal PrP from tonsillar tissue should not be ignored. Apart from a disposable tonsil-biopsy kit,[1] surgical instruments meant for intervention in tonsils, epiglottis, soft palate, tongue, pharynx, and nasopharynx should be sterilised by autoclaving at 132° for 5 h or by use of 2N NaOH for about 12 h. Sterilisation would interrupt inadvertent spread of abnormal PrP-laden germinal centres in lymphoid tissue in the region.
1 Hill AF, Zeidler M, Ironside J, Collinge J. Diagnosis of new variant Creutzfeldt-Jakob disease by tonsil biopsy. Lancet 1997; 349: 99-100.
2 Timon CI, Cafferkey MI, Welsh M. Fine-needle aspiration in recurrent tonsillitis. Arch Otolaryngol Head Neck Surg 1991; 117: 653-56.
ZR 2 Zitate
MH Biopsy; Creutzfeldt-Jakob Syndrome/*diagnosis/transmission; Human; Prions/*analysis; Tonsil/*pathology
AD Subhash C Arya, Centre for Logistical Research and Innovation, M-122 (of Part 2), Greater Kailash-II, New Delhi 110048, India
SP englisch
PO England
OR Prion-Krankheiten 1