Creutzfeldt-Jakob disease differential diagnosis: Difference between revisions
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{{CMG}} {{AE}} {{TS}} | {{CMG}} {{AE}} {{TS}} | ||
==Overview== | ==Overview== | ||
Creutzfeldt-Jakob disease must be differentiated from other causes of rapidly progressive [[dementia]], such as other neurodegenerative diseases, infections, Alzheimer's disease, vascular dementia, and dementia due to metabolic or toxic etiology.<ref name="pmid23229042">{{cite journal| author=Paterson RW, Torres-Chae CC, Kuo AL, Ando T, Nguyen EA, Wong K et al.| title=Differential diagnosis of jakob-creutzfeldt disease. | journal=Arch Neurol | year= 2012 | volume= 69 | issue= 12 | pages= 1578-82 | pmid=23229042 | doi=10.1001/2013.jamaneurol.79 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23229042 }} </ref> | |||
==Differential Diagnosis of Creutzfeldt-Jakob Disease== | ==Differential Diagnosis of Creutzfeldt-Jakob Disease== | ||
CJD should be differentiated from variant Creutzfeldt-Jakob disease and Mad Cow disease. | *CJD should be differentiated from variant Creutzfeldt-Jakob disease and Mad Cow disease. | ||
*Differential diagnosis of Creutzfeldt-Jakob disease includes the following: | |||
===Neurodegenerative Diseases=== | ===Neurodegenerative Diseases=== | ||
* [[Alzheimer disease]] | * [[Alzheimer disease]] | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Transmissible spongiform encephalopathies]] | [[Category:Transmissible spongiform encephalopathies]] | ||
Revision as of 20:06, 17 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2]
Overview
Creutzfeldt-Jakob disease must be differentiated from other causes of rapidly progressive dementia, such as other neurodegenerative diseases, infections, Alzheimer's disease, vascular dementia, and dementia due to metabolic or toxic etiology.[1]
Differential Diagnosis of Creutzfeldt-Jakob Disease
- CJD should be differentiated from variant Creutzfeldt-Jakob disease and Mad Cow disease.
- Differential diagnosis of Creutzfeldt-Jakob disease includes the following:
Neurodegenerative Diseases
- Alzheimer disease
- Dementia with Lewy bodies
- Frontotemporal dementia
- Corticobasal degeneration
- Normal pressure hydrocephalus
- Parkinsonian disorder
Autoimmune diseases
Infections
- Encephalitis
- Whipple disease
- Rabies
- Herpes simplex virus
- Postinfectious syndrome
Toxic or metabolic causes
- Vitamin B12 deficiency
- Hypothyroidism
- Side effects of drugs
- Wernicke-Korsakoff syndrome
- Urinary tract infection[1]
Clinical and pathologic characteristics of classic CJD and variant CJD:[2]
| Characteristic | Classic CJD | Variant CJD |
| Median age at death | 68 years | 28 years |
| Median duration of illness | 4-5 months | 13-14 months |
| Clinical signs and symptoms | Dementia; early neurologic signs | Prominent psychiatric/behavioral symptoms; painful dysesthesias; delayed neurologic signs |
| Periodic sharp waves on electroencephalogram | Often present | Often absent |
| Signal hyperintensity in the caudate nucleus and putamen on diffusion-weighted and FLAIR MRI | Often present | Often absent |
| Pulvinar sign on MRI | Not reported | Present in >75% of cases |
| Immunohistochemical analysis of brain tissue | Variable accumulation. | Marked accumulation of protease-resistant prion protein |
| Presence of agent in lymphoid tissue | Not readily detected | Readily detected |
| Increased glycoform ratio on immunoblot analysis of protease-resistant prion protein | Not reported | Marked accumulation of protease-resistant prion protein |
| Presence of amyloid plaques in brain tissue | May be present | May be present |
References
- ↑ 1.0 1.1 Paterson RW, Torres-Chae CC, Kuo AL, Ando T, Nguyen EA, Wong K; et al. (2012). "Differential diagnosis of jakob-creutzfeldt disease". Arch Neurol. 69 (12): 1578–82. doi:10.1001/2013.jamaneurol.79. PMID 23229042.
- ↑ Belay ED, Schonberger LB (2002). "Variant Creutzfeldt-Jakob disease and bovine spongiform encephalopathy". Clin. Lab. Med. 22 (4): 849–62, v–vi. PMID 12489284.