Towards an age-dependent transmission model of acquired and sporadic Creutzfeldt-Jakob disease

INTRODUCTION: Sporadic Creutzfeldt-Jakob disease (sCJD) might be transmitted by surgery. The purpose of this study was to investigate potential susceptibility to sCJD from surgery at juvenile age and in early adulthood. METHODS: From Danish and Swedish national registries we identified 167 definite...

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Detalles Bibliográficos
Autores: Pedro-Cuesta, Jesus de, Mahillo-Fernandez, Ignacio, Calero, Miguel, Rábano, Alberto, Cruz, Mabel, Siden, Åke, Martínez-Martín, Pablo, Laursen, Henning, Ruiz-Tovar, Maria, Mølbak, Kåre
Tipo de recurso: artículo
Fecha de publicación:2014
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/6867
Acceso en línea:http://hdl.handle.net/20.500.12105/6867
Access Level:acceso abierto
Palabra clave:Adult
Age Factors
Case-Control Studies
Creutzfeldt-Jakob Syndrome
Data Interpretation, Statistical
Female
Humans
Logistic Models
Male
Middle Aged
Models, Statistical
Registries
Risk Factors
Young Adult
Descripción
Sumario:INTRODUCTION: Sporadic Creutzfeldt-Jakob disease (sCJD) might be transmitted by surgery. The purpose of this study was to investigate potential susceptibility to sCJD from surgery at juvenile age and in early adulthood. METHODS: From Danish and Swedish national registries we identified 167 definite and probable sCJD cases with onset from 1987 through 2003, and 835 age-, sex- and residence-matched controls along with their surgical histories. Main, anatomically or etiologically classified surgical procedures followed by a ≥20-year lag were analyzed using logistic regression, and stratified by age at first-registered surgical discharge. RESULTS: The risk of having a diagnosis of CJD depended strongly on age at first surgery with odds ratio (OR) of 12.80 (95% CI 2.56-64.0) in patients <30 years, 3.04 (95% 1.26-7.33) in 30-39 years, and 1.75 (95% CI 0.89-3.45) in ≥40 years, for anatomically classified surgical procedures. Similar figures were obtained for etiologically classified surgical procedures. CONCLUSIONS: Risk of surgical-acquired sCJD depends on age at exposure; this pattern is similar to age-specific profiles reported for CJD accidentally transmitted by human pituitary-derived growth hormone and susceptibility curves for variant CJD estimated after adjustment for dietary exposure to bovine spongiform encephalopathy. There might be an age-at-exposure-related susceptibility to acquire all CJD forms, including sCJD from routine surgery.