Abstract
Genetic Creutzfeldt-Jakob disease (gCJD) with E200K mutation is one of the common subtypes of human genetic prion diseases worldwide. In this study, we systematically analyzed 30 Chinese E200K gCJD cases for their epidemiological, clinical, laboratory and genetic features. The patients came from 12 different provinces, majority in northern part of China. The onset age varied from 42 to 71 year-old (y), with the median of was 57 y. The CYP4X1 gene rs9793471 SNP was tested. Only one patient’s rs9793471 genotype was GA and the others’ were AA. The gender ratio (M: F) was 1:1.73 (11:19). The foremost symptoms and clinical progression of Chinese E200K gCJD patients were quite similar as sporadic CJD cases. Only a few cases (4/30) recalled clearly disease related family history. 74.1% (20/27), 86.7% (26/30) and 50.0% (13/26) of the cases were CSF 14-3-3 positive, sCJD associated abnormalities on MRI and special PSWC on EEG, respectively. The median clinical duration was 9 months (varying from 2 to 26 months). All 30 Chinese E200K gCJD patients were M129M and E219E homozygous. 21 members from 3 families conducted PRNP sequencing and 16 asymptomatic carriers of E200K mutation with M129M and E219E homozygous were identified. This is the largest study on E200K gCJD patients in China, which would benefit to the knowledge of E200K gCJD.
Highlights
Genetic Creutzfeldt-Jakob disease with E200K mutation is one of the common subtypes of human genetic prion diseases worldwide
The epidemiological, clinical, genetic and laboratory characteristics of 30 Chinese E200K Genetic Creutzfeldt-Jakob disease (gCJD) cases were comparatively investigated based on the onset age and gender
Analysis of the permanent addresses of the patients showed that they came from 12 provinces. 7 cases were from Tianjin (TJ), 5 from Hebei (HB), 4 from Henan (HN), 2 from Beijing (BJ), Zhejiang (ZJ), Neimenggu (NMG), Shandong (SD), and Jiangxi (JX), 1 from Guangdong (GD), Guizhou (GZ), Jilin (JL), and Heilongjiang (HLJ), respectively
Summary
Genetic Creutzfeldt-Jakob disease (gCJD) with E200K mutation is one of the common subtypes of human genetic prion diseases worldwide. 21 members from 3 families conducted PRNP sequencing and 16 asymptomatic carriers of E200K mutation with M129M and E219E homozygous were identified This is the largest study on E200K gCJD patients in China, which would benefit to the knowledge of E200K gCJD. Familial/genetic CJD (fCJD/gCJD) accounts for about 10–15% of CJD cases worldwide[2,3], which closely links to various pathogenic mutations in the prion protein-encoding gene, PRNP. According to the surveillance data from Chinese CJD Surveillance Center, E200K gCJD is the third most common genetic prion disease in Chinese, after D178N FFI and T188K gCJD7–9 In this prospective study, the epidemiological, clinical, genetic and laboratory characteristics of 30 Chinese E200K gCJD cases were comparatively investigated based on the onset age and gender. Items Age of onset (median) Foremost symptoms Progressive dementia Mental problems Cerebellum symptoms Pyramidal & extrapyramidal symptoms Sleeping disturbances Major symptoms Dementia Myoclonus Visual or cerebellar disturbance Pyramidal and extrapyramidal symptoms Mutism Examinations 14-3-3a EEGb MRI
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