Stoeck Katharina, Hess Klaus, Amsler Lorenz, Eckert Tobias, Zimmermann Dieter, Aguzzi Adriano, Glatzel Markus
Institute of Neuropathology, University Hospital of Zürich, Schmelzbergstrasse 12, 8091 Zurich, Switzerland.
J Neurol. 2008 Oct;255(10):1464-72. doi: 10.1007/s00415-008-0900-0. Epub 2008 Oct 29.
Incidences of human transmissible spongiform encephalopathies are monitored by national registries in the majority of countries in Western Europe. During the past 13 years incidences for Creutzfeldt-Jakob disease (CJD) in Switzerland fluctuated between 0.4 and 2.63 cases/10(6) inhabitants. We have compared clinicpathological patient profiles including geographic and gender distribution, age at disease onset, duration of disease, clinical symptoms, and recognized or hypothetical risk factors for CJD, genetic risk factors, biochemical and histopathological data for two cohorts of Swiss sporadic CJD patients from years of regular sporadic CJD incidence (1996-2000, mean incidence 1.3 cases/10(6) inhabitants, n = 47) to Swiss sporadic CJD patients from years of elevated sporadic CJD incidence (2001-2004, mean incidence 2.3 cases/10(6) inhabitants, n = 73). Sporadic CJD patients from the cohort with elevated sporadic CJD incidence presented with a higher frequency of rare sporadic CJD subtypes. Patients of these subtypes were significantly older and showed a skewed male/female ratio when compared to published patients of identical sporadic CJD-types or to patients from the 1996-2000 cohort and indicates that improved detection of rare sporadic CJD subtypes may have contributed to increased incidence.
在西欧的大多数国家,人类可传播性海绵状脑病的发病率由国家登记处进行监测。在过去13年中,瑞士克雅氏病(CJD)的发病率在每10^6居民0.4至2.63例之间波动。我们比较了两组瑞士散发性CJD患者的临床病理特征,包括地理和性别分布、发病年龄、病程、临床症状以及已确认或假设的CJD危险因素、遗传危险因素、生化和组织病理学数据。一组是来自散发性CJD发病率正常年份(1996 - 2000年,平均发病率为每10^6居民1.3例,n = 47)的瑞士散发性CJD患者,另一组是来自散发性CJD发病率升高年份(2001 - 2004年,平均发病率为每10^6居民2.3例,n = 73)的瑞士散发性CJD患者。散发性CJD发病率升高组的散发性CJD患者中,罕见散发性CJD亚型的出现频率更高。与已发表的相同散发性CJD类型患者或1996 - 2000年组的患者相比,这些亚型的患者年龄显著更大,且男女比例失衡,这表明对罕见散发性CJD亚型检测的改善可能导致了发病率的上升。