Connecticut medicine · 2007
A systematic review of sporadic Creutzfeldt-Jakob disease clusters: do clinical, epidemiologic, and genetic features reflect infectious clustering mechanisms?
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Barash Jed A, Dziura James
Аннотация
BACKGROUND: While the cause of sporadic Creutzfeldt-Jakob disease (sCJD) is unknown, case clustering could suggest infectious transmission in some instances.
METHODS: Publications of sCJD clusters were systematically identified and pooled to determine if their clinical, epidemiologic, and genetic features reflected potential infectious clustering mechanisms.
RESULTS: The search yielded five clusters involving 23 cases. Most notably, among 12 cases with reported residential histories, patients lived for a median of 30.0 years (25th percentile: 26.5 years; 75th percentile: 51.0 years) in their respective cluster regions. Of 19 cases that underwent genotyping for polymorphic codon 129, seventeen were methionine homozygotes (89.5%; 95% CI 67.4-98.3%); none were heterozygous.
CONCLUSIONS: Prolonged residency duration and Prnp codon 129 methionine homozygosity may be consistent with underlying disease-clustering mechanisms, although larger, controlled investigations might help to exclude the possibility that these findings reflect the normal distribution of these features among relevant comparison populations.
METHODS: Publications of sCJD clusters were systematically identified and pooled to determine if their clinical, epidemiologic, and genetic features reflected potential infectious clustering mechanisms.
RESULTS: The search yielded five clusters involving 23 cases. Most notably, among 12 cases with reported residential histories, patients lived for a median of 30.0 years (25th percentile: 26.5 years; 75th percentile: 51.0 years) in their respective cluster regions. Of 19 cases that underwent genotyping for polymorphic codon 129, seventeen were methionine homozygotes (89.5%; 95% CI 67.4-98.3%); none were heterozygous.
CONCLUSIONS: Prolonged residency duration and Prnp codon 129 methionine homozygosity may be consistent with underlying disease-clustering mechanisms, although larger, controlled investigations might help to exclude the possibility that these findings reflect the normal distribution of these features among relevant comparison populations.