NR ATNG
AU Preusser,M.; Ströbel,T.; Gelpi,E.; Eiler,M.; Broessner,G.; Schmutzhard,E.; Budka,H.
TI Alzheimer-type neuropathology in a 28-year old patient with iatrogenic Creutzfeldt-Jakob disease after dural grafting
QU International Conference - Prion 2005: Between fundamentals and society's needs - 19.10.-21.10.2005, Congress Center Düsseldorf - Poster Session: Human prions, risk of blood products, and therapy HUMAN-04
PT Konferenz-Poster
AB e report the autopsy case of a 28-year old male patient who had received a cadaverous dura mater graft after a traumatic open skull fracture with tearing of dura at the age of 5 years. A clinical suspicion of Creutzfeldt-Jakob disease (CJD) was confirmed by a brain biopsy 5 months prior to death and by autopsy, thus warranting the diagnosis of iatrogenic CJD (iCJD) according to WHO criteria. Immunohistochemistry showed widespread cortical depositions of disease-associated prion protein (PrPsc) in a synaptic pattern and western blot analysis identified PrPsc of type 2A according to Parchi et al. Surprisingly, we found Alzheimer-type senile plaques and cerebral amyloid angiopathy in widespread areas of the brain. Plaque-type and vascular amyloid was immunohistochemically identified as deposits of beta-A4 peptide. CERAD criteria for diagnosis of definite Alzheimer's disease (AD) were met in the absence of neurofibrillar tangles or alpha-synuclein immunoreactive inclusions. There was no family history of AD, CJD, or any other neurological disease, and genetic analysis showed no disease-specific mutations of the prion protein, presenilin 1 and 2, or amyloid precursor protein genes. This case represents 1. the iCJD case with the longest incubation time after dural grafting reported so far, 2. the youngest documented patient with concomitant CJD and Alzheimer-type neuropathology to date, 3. the first description of Alzheimer type-changes in iCJD, and 4. the second case of iCJD in Austria. Despite the young patient age, the Alzheimer-type changes may be an incidental finding, possibly related to the childhood trauma.
AD M.Preusser, T.Stroebel, E.Gelpi, H.Budka, Institute of Neurology, Medical University Vienna, Austria; E.Gelpi, H.Budka, Austrian Reference Centre for Human Prion Diseases (OERPE), General Hospital Vienna, Austria; M.Eiler, Department of Neurology, LKH Rankweil, Austria; G.Broessner, E.Schmutzhard, Department of Neurology, Medical University Innsbruck, Austria
SP englisch
PO Deutschland