Background: Although more than 160 cases of iatrogenic Creutzfeldt-Jakob disease (iCJD) from human growth hormone (hGH) treatment have been documented, to our knowledge abnormal cerebellar findings on magnetic resonan...Background: Although more than 160 cases of iatrogenic Creutzfeldt-Jakob disease (iCJD) from human growth hormone (hGH) treatment have been documented, to our knowledge abnormal cerebellar findings on magnetic resonance imaging (MRI) have not been reported. Objective: To report a case of hGH-related iCJD with abnormal cerebellar MRI findings on fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted MRI (DWI). Design: Case report. Setting: Outpatient neurology clinic at a university medical center. Patient: A 33-year old man who had sub acute gait ataxia and blurred vision. Results: Beginning 19 years prior, this pa tient had received cadaveric pituitary-derived hGH treatment for at least 5 yea rs. Magnetic resonance imaging revealed FLAIR and DWI abnormalities, particularl y in the cerebellum. He died 7 months after disease onset of autopsyconfirmed iC JD. Pathological changes corresponded largely to MRI findings. Conclusions: To o ur knowledge, this is the first case of hGH-related iCJD with FLAIR and DWI abn ormalities within the cerebellum. As symptoms referable to the cerebellum occur early in iCJD, it suggests that these MRI sequences may allow earlier diagnosis of this form of prion disease.展开更多
文摘Background: Although more than 160 cases of iatrogenic Creutzfeldt-Jakob disease (iCJD) from human growth hormone (hGH) treatment have been documented, to our knowledge abnormal cerebellar findings on magnetic resonance imaging (MRI) have not been reported. Objective: To report a case of hGH-related iCJD with abnormal cerebellar MRI findings on fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted MRI (DWI). Design: Case report. Setting: Outpatient neurology clinic at a university medical center. Patient: A 33-year old man who had sub acute gait ataxia and blurred vision. Results: Beginning 19 years prior, this pa tient had received cadaveric pituitary-derived hGH treatment for at least 5 yea rs. Magnetic resonance imaging revealed FLAIR and DWI abnormalities, particularl y in the cerebellum. He died 7 months after disease onset of autopsyconfirmed iC JD. Pathological changes corresponded largely to MRI findings. Conclusions: To o ur knowledge, this is the first case of hGH-related iCJD with FLAIR and DWI abn ormalities within the cerebellum. As symptoms referable to the cerebellum occur early in iCJD, it suggests that these MRI sequences may allow earlier diagnosis of this form of prion disease.
