Larue Sandrine, Verreault Steve, Gould Peter, Coulthart Michael B, Bergeron Catherine, Dupré Nicolas
Department of Neurological Sciences, CHAUQ - Enfant-Jésus, Laval University, Quebec City, QC, Canada.
Can J Neurol Sci. 2006 May;33(2):243-5. doi: 10.1017/s0317167100005072.
Clinical diagnosis of Creutzfeldt-Jakob disease (CJD) is based on the classical triad of rapidly progressive dementia, myoclonus and abnormal EEG. The 200k mutation within the gene encoding PrP, located on the short arm of chromosome 20, accounts for more than 70% of families with CJD worldwide.
Herein, we report a patient who developed persistent dry cough and classical signs of CJD, including severe cognitive decline, cerebellar signs, and myoclonic jerks, leading to death a few weeks after disease onset. Mutation screening showed that he had the 200k point mutation in the PRNP gene. His mother had died twenty years earlier with neuropathologically confirmed CJD. She had presented a rapidly progressive ataxia with myoclonus, dementia, visual hallucinations, and the same persistent dry cough.
The clinical presentation of this familial CJD case with persistent dry cough is quite unusual. Therefore, a neurological etiology should be sought when confronted with an unexplained persistent cough.
克雅氏病(CJD)的临床诊断基于快速进展性痴呆、肌阵挛和异常脑电图这一经典三联征。位于20号染色体短臂上的编码PrP的基因内的200k突变,在全球范围内超过70%的CJD家族中存在。
在此,我们报告一名患者,其出现持续性干咳以及CJD的典型症状,包括严重认知衰退、小脑体征和肌阵挛性抽搐,发病几周后死亡。突变筛查显示他在PRNP基因中有200k点突变。他的母亲在二十年前死于经神经病理学证实的CJD。她曾表现出快速进展性共济失调伴肌阵挛、痴呆、视幻觉以及同样的持续性干咳。
该例伴有持续性干咳的家族性CJD病例的临床表现颇为罕见。因此,当面对不明原因的持续性咳嗽时,应探寻神经学病因。