Brain biopsies requiring Creutzfeldt-Jakob disease precautions in the Republic of Ireland 2005-2016
| Autor: | Michael A. Farrell, R. Howley, Hugh Kearney, J. Heffernan, D. Chen, C. Heaney, T. Loftus, Francesca Brett, F. Cunningham, Seamus Looby, A. Chalissery |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Biopsy Neuropathology Disease History 21st Century Creutzfeldt-Jakob Syndrome 03 medical and health sciences 0302 clinical medicine Risk Factors mental disorders Clinical information medicine Humans Medical diagnosis Psychiatry business.industry Brain General Medicine Middle Aged nervous system diseases Case selection 030220 oncology & carcinogenesis Cohort Female Differential diagnosis CJD - Creutzfeldt-Jakob disease business Ireland 030217 neurology & neurosurgery |
| Zdroj: | Irish journal of medical science. 187(2) |
| ISSN: | 1863-4362 |
| Popis: | Creutzfeldt-Jakob disease (CJD) risk precautions are required when performing brain biopsies on patients with a dementing illness and in ‘risk’ groups. The impact on a diagnostic neuropathology service is considerable. We sought to determine if better case selection might reduce the necessity for application of CJD risk precautions. We reviewed the clinical information, contributory investigations and final neuropathologic diagnosis in a cohort of patients (n = 21), referred to the National CJD Surveillance Centre between January 1, 2005, and December 31, 2016. Of this 21-patient cohort, five were positive for CJD, four belonged to the ‘at risk of CJD’ category requiring brain surgery, while the remaining 12 were referred to the National CJD Surveillance Unit with CJD as part of their differential diagnosis. CJD was confirmed in 5/21 (three sporadic [s]CJD, one variant [v]CJD and one iatrogenic [i] CJD). CJD was clinically probable in 4/5 proven CJD patients (80%). The patients (n = 4) in the ‘at risk of CJD’ group were diagnosed with tumour (n = 2), inflammation (n = 1) and non-specific changes (n = 1). Of the remaining 12 patients (in whom CJD was included in the differential diagnosis), the final neuropathologic diagnoses included tumour (n = 2), neurodegenerative (n = 2), inflammatory (n = 1), metabolic (n = 2), vascular (n = 2) and non-specific gliosis (n = 3). More often than not, the clinical suspicion of CJD was not borne out by the final neuropathological diagnosis. Failure by clinicians to adhere to the recommended CJD investigation algorithm impacts adversely on the neuropathology workload and causes unnecessary concern among operating theatre, laboratory and nursing personnel. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink