Pastuszak Żanna, Tomczykiewicz Kazimierz, Stępień Adam, Piusińska-Macoch Renata, Klimczuk Joanna, Rolewska Agnieszka, Galbarczyk Dariusz
Department of Neurology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, Warsaw, Poland.
Department of Neurology, Specialized Regional Hospital, Ciechanów, Poland.
Pol Merkur Lekarski. 2017 Feb 20;42(248):84-86.
Creutzfeldt-Jakob disease (CJD) is a rare syndrome of central nervous system caused by infectious protein called prion. There are four types of CJD: sporadic (sCJD), familial (fCJD), jatrogenic (jCJD) and variant (vCJD). The most frequent symptoms are rapidly progressing dementia, mioclonias, akinetic mutism and signs of cerebellum dysfunction. In sCJD, MRI often shows high signal intensity in the putamen and caudate nucleus on T2-weighted images while in vCJD pulvinar sign is often observed. 70% patients with CJD often has characteristic generalized periodic sharp wave pattern in electroencephalography. In case of 90% patients with CJD 14-3-3 protein is present in cerebrospinal fluid. Neuropathological studies play an important role in disease diagnosis. CJD incidence is 0.5-1 on 1000000 people but some cases can be undiagnosed. Presented study is a description of woman with sCJD confirmed with histopathological study. Since childhood patient had psychotic symptoms and behavior disturbances. Patient wasn't diagnosed due to this symptoms. Few months before admission to hospital her condition was getting worse. Symptoms of cerebellum, pyramidal and extrapyramidal system occurred. In cerebrospinal fluid 14-3-3 protein was detected. In EEG and MRI changes specific for sCJD was observed. After three months patient died.
克雅氏病(CJD)是一种由称为朊病毒的传染性蛋白质引起的罕见中枢神经系统综合征。CJD有四种类型:散发性(sCJD)、家族性(fCJD)、医源性(jCJD)和变异型(vCJD)。最常见的症状是快速进展的痴呆、肌阵挛、运动不能性缄默和小脑功能障碍的体征。在sCJD中,MRI在T2加权图像上常显示壳核和尾状核高信号强度,而在vCJD中常观察到丘脑枕征。70%的CJD患者脑电图常有特征性的广泛性周期性锐波图形。90%的CJD患者脑脊液中存在14-3-3蛋白。神经病理学研究在疾病诊断中起重要作用。CJD的发病率为每100万人中有0.5 - 1例,但有些病例可能未被诊断出来。本研究描述了一名经组织病理学研究确诊为sCJD的女性。患者自幼就有精神症状和行为障碍,因这些症状未被诊断。入院前几个月,她的病情恶化,出现了小脑、锥体和锥体外系症状。脑脊液中检测到14-3-3蛋白,脑电图和MRI观察到sCJD特有的变化。三个月后患者死亡。