Wang Yin, Qiao Xiang-Yang, Zhao Chong-Bo, Gao Xiang, Yao Zhen-Wei, Qi Ling, Lu Chuan-Zhen
Department of Neuropathology, Institute of Neurology, Huashan Hospital of Fudan University, 12 Wu Lu Mu Qi Zhong Road, Shanghai 200040, China.
Neuropathology. 2006 Oct;26(5):429-32. doi: 10.1111/j.1440-1789.2006.00704.x.
The authors found a female patient aged 33-years with dementia and cerebellar ataxia rapidly progressing for a year. EEG tracings were abnormal but without features of typical CJD. The patient died 13 months after the onset of illness. Biopsy of her cerebral cortex showed moderate spongiform changes, neuronal loss and gliosis. Numerous deposits of eosinophilic substance amorphous or in the shape of Kuru plaques were disclosed in the cerebral cortex. All deposits stained strongly with monoclonal 3F4 antibody to human prion protein. Genetic studies disclosed the Pro to Leu point mutation at codon 102 with a 102 Leu-129 Met in the PrP gene. Codon 129 was heterozygous for Met/Val, and codon 219 was homozygous for Glu/Glu. It was established; moreover, that the patient's grandfather had a similar disease and died at age 48 and the patient's brother died after a 10-year long neurological disease diagnosed as hereditary cerebellar ataxia. On the basis of clinical, neuropathological and genetic findings, the authors diagnosed the Gerstmann-Sträussler-Scheinker disease, a familial prion disease with an autosomal dominant character. This is the first report on this disease in China.
作者发现一名33岁女性患者,患有痴呆和小脑共济失调,病程快速进展达一年。脑电图描记异常,但无典型克雅氏病特征。患者于发病13个月后死亡。其大脑皮质活检显示中度海绵状改变、神经元丢失和胶质细胞增生。大脑皮质中发现大量嗜酸性物质沉积,呈无定形或库鲁病斑块状。所有沉积物均被抗人朊蛋白单克隆3F4抗体强烈染色。基因研究发现朊蛋白基因第102密码子发生脯氨酸到亮氨酸的点突变,伴有102位亮氨酸-129位甲硫氨酸突变。第129密码子为甲硫氨酸/缬氨酸杂合,第219密码子为谷氨酸/谷氨酸纯合。此外,已确定患者的祖父患有类似疾病,48岁时死亡,患者的兄弟在被诊断为遗传性小脑共济失调的10年神经系统疾病后死亡。基于临床、神经病理学和基因学发现,作者诊断为格斯特曼-施特劳斯勒-谢inker病,一种常染色体显性遗传的家族性朊蛋白病。这是中国关于该疾病的首例报告。