Variant Creutzfeldt–Jakob disease

Variant Creutzfeldt–Jakob disease
Other namesNew variant Creutzfeldt–Jakob disease (nvCJD) (dated), human mad cow disease, human BSE (colloquial)
Biopsy of the tonsil in variant CJD. PrPsc deposits are stained brown and are visible.
SpecialtyInfectious disease, Neurology
SymptomsInitial: Psychiatric problems, behavioral changes, painful sensations[1]
Later: Poor coordination, dementia, hallucinations, involuntary movements[2]
Complicationsaspiration pneumonia, akinetic mutism
Usual onsetYears after initial exposure[3]
Duration~13-month life expectancy after onset of symptoms[1]
CausesPrions, specifically PrPBSE
Risk factorsEating beef from cows with bovine spongiform encephalopathy[3][4]
Diagnostic methodSuspected based on symptoms, confirmed by brain biopsy, Protein misfolding cyclic amplification (PMCA), or Real-time quaking-induced conversion (RT-QuIC)[3]
Differential diagnosisMultiple sclerosis, classic Creutzfeldt-Jakob disease
PreventionNot eating contaminated beef
TreatmentSupportive care[5]
MedicationPentosan polysulfate (experimental), morphine, methadone (for pain relief), clonazepam, valproate (for involuntary movements), haloperidol (for agitation)
PrognosisAlways fatal[6]
FrequencyFewer than 250 reported cases as of 2012[7]
Deaths178 in the United Kingdom as of 2024[8]

Variant Creutzfeldt–Jakob disease (vCJD), formerly known as new variant Creutzfeldt–Jakob disease (nvCJD) and referred to colloquially as "mad cow disease" or "human mad cow disease" to distinguish it from its BSE counterpart, is a fatal type of brain disease within the transmissible spongiform encephalopathy family.[7] Initial symptoms include psychiatric problems, behavioral changes, and painful sensations.[1] In the later stages of the illness, patients may exhibit poor coordination, dementia and involuntary movements.[2] The length of time between exposure and the development of symptoms is unclear, but is believed to be years to decades.[3] Average life expectancy following the onset of symptoms is 13 months.[1]

It is caused by prions, which are misfolded proteins.[9] Spread is believed to be primarily due to eating beef infected with bovine spongiform encephalopathy (BSE).[7][9] Infection is also believed to require a specific genetic susceptibility.[4][7] Spread may potentially also occur via blood products or contaminated surgical equipment.[10] Diagnosis is by brain biopsy but can be suspected based on certain other criteria.[3] It is different from typical Creutzfeldt–Jakob disease, though both are due to prions.[9]

Treatment for vCJD involves supportive care.[5] As of 2020, 178 cases of vCJD have been recorded in the United Kingdom,[11] due to a 1990s outbreak, and 50 cases in the rest of the world.[7] The disease has become less common since 2000.[7] The typical age of onset is less than 30 years old.[3] It was first identified in 1996 by the National CJD Surveillance Unit in Edinburgh, Scotland.[7]

  1. ^ a b c d "Clinical and Pathologic Characteristics | Variant Creutzfeldt-Jakob Disease, Classic (CJD)". CDC. 10 February 2015. Retrieved 22 January 2018.
  2. ^ a b Cite error: The named reference CDC2015Criteria was invoked but never defined (see the help page).
  3. ^ a b c d e f "Classic CJD versus Variant CJD". CDC. 11 February 2015. Archived from the original on August 31, 2015. Retrieved 23 January 2018.
  4. ^ a b Ironside JW (July 2010). "Variant Creutzfeldt-Jakob disease". Haemophilia. 16 (Suppl 5): 175–180. doi:10.1111/j.1365-2516.2010.02317.x. PMID 20590878. S2CID 24635924.
  5. ^ a b "Treatment Variant Creutzfeldt-Jakob Disease". CDC. 10 February 2015. Retrieved 23 January 2018.
  6. ^ "Variant Creutzfeldt-Jakob Disease (VCJD) | Prion Diseases". U.S. Centers for Disease Control and Prevention (CDC). 25 January 2022.
  7. ^ a b c d e f g Ironside JW (2012). "Variant Creutzfeldt-Jakob disease: an update". Folia Neuropathologica. 50 (1): 50–56. PMID 22505363.
  8. ^ "Creutzfeldt-Jakob disease in the UK (by calendar year)" (PDF). www.cjd.ed.ac.uk.
  9. ^ a b c "About vCJD". CDC. 10 February 2015. Retrieved 22 January 2018.
  10. ^ Ferri FF (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 343. ISBN 9780323529570.
  11. ^ Gill ON, Spencer Y, Richard-Loendt A, Kelly C, Brown D, Sinka K, et al. (June 2020). "Prevalence in Britain of abnormal prion protein in human appendices before and after exposure to the cattle BSE epizootic". Acta Neuropathologica. 139 (6): 965–976. doi:10.1007/s00401-020-02153-7. PMC 7244468. PMID 32232565.