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Possible Link Between CJD and Human Growth Hormone

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Possible Link Between CJD and Human Growth Hormone


NEW YORK (Reuters Health) May 22 - Dutch researchers report the case of a man who developed Creutzfeldt-Jakob disease (CJD) 38 years after receiving a low-dose of human derived growth hormone during a diagnostic procedure.

Reporting in the June issue of the Journal of Neurology, Neurosurgery, and Psychiatry, Dr. C. M. van Duijn, from Erasmus University Medical Centre Rotterdam, and colleagues describe the case of a 47-year-old man who developed paraesthesia followed by rapidly progressive ataxia.


One month after presentation, the patient's condition rapidly declined and he died 5 months after hospital admission. Dr. van Duijn's team had made a clinical diagnosis of CJD, which was confirmed at necropsy.


The patient's history revealed that at 9 years of age he was given 6 IU of human growth hormone over 5 days to rule out growth hormone deficiency.


Dr. van Duijn's team notes that this is the second Dutch patient to die from CJD after human growth hormone treatment. In the first case, the woman had been treated with intramuscular injections of human growth hormone over several years.


When the women was 39 years of age, 27 years after starting human growth hormone treatment, she developed an ataxic gate, slurred speech, sensory disorders, and myoclonus. CJD was confirmed postmortem.


Based on this woman's case, a retrospective study was undertaken to find all 564 registered patients who had been treated with human growth hormone before 1985. As of January 1995, none of these subjects was suspected of having CJD, the researchers note.


"An incubation period as long as 38 years had never been reported for iatrogenic CJD," Dr. van Duijn's group notes. They speculate that the long incubation period was due to the low-dose of human growth hormone the patient received.


Dr. van Duijn and colleagues conclude that "since our patient was one of the first in the world to receive human growth hormone, this case indicates that still more patients with iatrogenic CJD can be expected in the coming years. Another implication of our study is that CJD can develop even after a low dose of human growth hormone."


They stress that "this case once more testifies that worldwide close monitoring of any form of iatrogenic CJD is mandatory."


J Neurol Neurosurg Psychiatry 2002;72:792-793.

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