Abstract
To elucidate the association between medical procedures and sporadic Creutzfeldt-Jakob disease (sCJD), we analyzed medical procedures (any surgical procedure, neurosurgery, ophthalmic surgery, and blood transfusion) for patients registered by the CJD Surveillance Committee in Japan during 1999-2008. We conducted an age-stratified case-control study with 753 sCJD patients and 210 controls and a study of patients who underwent neurosurgical or ophthalmic surgical procedures at the same hospital. Although the control group was relatively small, no evidence was found that prion disease was transmitted through the investigated medical procedures before onset of sCJD. After onset of sCJD, 4.5% of the sCJD patients underwent operations, including neurosurgical for 0.8% and ophthalmic for 1.9%; no special precautions against transmission of prion diseases were taken. Fortunately, we have not identified patients with prion disease attributed to these operations. Our findings indicate that surgical procedures or blood transfusion had little effect on the incidence of sCJD.
Highlights
Prion disease is characterized by spongiform change and abnormal prion protein deposition in the brain and is transmissible under certain situations
Surgical Procedures after Onset of sporadic Creutzfeldt-Jakob disease (sCJD) Except for 2 patients suspected of having prion disease, who had undergone brain biopsy with disposable instruments, 34 (4.5%) of 760 sCJD patients underwent some type of surgical procedure before the diagnosis of prion disease, including neurosurgery in 6 (0.8%), ophthalmic surgery in 14 (1.8%), and other surgery in 16 (2.1%)
In the previous case–control study and in our study, receipt of a blood transfusion was not shown to be a significant risk for CJD [2,3,4,5,6,7,8,9,10]
Summary
Prion disease is characterized by spongiform change and abnormal prion protein deposition in the brain and is transmissible under certain situations. In Japan, 66 (8.6%) of 766 patients with prion diseases had iatrogenic cases that were all dCJD [12], and the outbreak of iatrogenic CJD required a new study about the association between sCJD and medical procedures in Japan. For each patient with a history of surgery, we collected information about the underlying disease from the patient’s family, including the date and hospital in which the operation was performed.
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