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Table 1 Clinical, molecular and pathological features of the iatrogenic CJD patients of this study and sporadic CJDMM1

From: Distinct pathological phenotypes of Creutzfeldt-Jakob disease in recipients of prion-contaminated growth hormone

Prion disease

GH-CJDMM1

GH-CJDMM1

GH-CJDMM1

dCJDMM1

sCJDMM1 (203 cases)a

Case

1 (index case)

2

3

4

 

Clinical data

     

Disease presentation

Ataxia, weight loss and insomnia.

Ataxia and slurred speech.

Left leg numbness with broad based gait.

Visual changes and ataxic gait.

Rapidly progressive cognitive decline; occasionally cortical visual disturbances, ataxia, and myoclonus.

Age (years)/gender

50/male

54/male

40/female

39/female

65.5b (42–91)c

Disease duration (months)

14

2

2

4

3.9b (1–18)c

Incubation time (years)

38d

41.5d

26.3d

6e

 

Molecular features

     

resPrPSc type

1

1

1

1

1

Codon 129 genotype

Met/Met

Met/Met

Met/Met

Met/Met

Met/Met

Histopathology (differences with sCJDMM1 underlined)

     

PrP plaques

     

Kuru

+++

-

-

-

-

Florid

+

-

-

-

-

Eosinophilic

+++

-

-

-

-

SDf/gliosis

     

Severity

     

Hippocampus

++/−

−/−

−/−

−/−

−/−

SNg of midbrain

++/+++

−/−

−/−

−/−

−/−

Topography (SD only)

Severe in subcortical regions; preferentially in layers IV-VI of cerebral cortex (cc); cerebellar molecular layer, focal.

Less severe in occipital than frontal cc; entorhinal cc and basal ganglia spared; occasionally most severe in deep layers of the cc; cerebellar molecular layer, focal.

More severe in occipital than frontal cc; entorhinal cc and basal ganglia affected; occasionally most severe in deep layers of cc; cerebellar molecular layer, ubiquitous.

All layers of cc affected; more severe in occipital than frontal cc; entorhinal cc and basal ganglia affected; cerebellar molecular layer, focal.

All layers of cc affected; more severe in the occipital than frontal cc; entorhinal cc and basal ganglia affected; cerebellar molecular layer, focal.

PrP IHCh cerebellum

PrP “stellate”, kuru plaques, plaque-like; occasionally “brush stroke-like”.

“brush stroke-like”

“brush stroke-like”

“brush stroke-like”

“brush stroke-like”

  1. a[19, 46]; bmean; crange; considered from the dthe midpoint of treatment with GH or ethe time of grafting surgery to the appearance of the first clinical sign/symptoms; fSD: spongiform degeneration; gSN: substantia nigra; hIHC: immunohistochemistry; (−) absent, (+) mild, (++) moderate, (+++) severe