engleski

Iatrogenic Creutzfeldt-Jakob disease acquired with lyophilized dura mater graft

Creutzfeld-Jakob disease (CJD) is a lethal transmissible disorder. Prion protein is considered to be a transmissible agent. A 37-year-old patient with CJD is presented, who had received a cadaveric dura mater graft 12 years before the onset of neurologic symptoms. Pure collagen implant obtained from bovine pericardium, Lyoplant was used. Analysis of the prion protein (PrP) gene was performed on genomic DNA according to standard procedures. There was no mutation in the open reading frame. The PrP gene was homozygous for valin at the polymorphic codon 129. Cerebrospinal fluid analysis for 14-3-3 proteine was positive. Autopsy was not performed. It is reported on the first Croatian patient who most likely acquired CJD consequentially to the use of cadaveric dura mater graft. It is manifest that the awareness of iatrogenic transmission of CJD and adoption of preventive measures are the only effective way to stop the spread of CJD among surgically treated patients. Therefore, the use of autologous tissue or durapatch, a fully synthetic material of the implant, sterilized with ethylene oxide process, is recommended.

Prions; CJD; Dura graft

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