Variant CJD infection in the spleen of a neurologically asymptomatic UK adult patient with haemophilia


Peden, A; McCardle, L; Head, MW; Love, S; Ward, HJT; Cousens, SN; Keeling, DM; Millar, CM; Hill, FGH; Ironside, JW; (2010) Variant CJD infection in the spleen of a neurologically asymptomatic UK adult patient with haemophilia. Haemophilia, 16 (2). pp. 296-304. ISSN 1351-8216 DOI: https://doi.org/10.1111/j.1365-2516.2009.02181.x

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Abstract

All UK patients with bleeding disorders treated with any UK-sourced pooled factor concentrates between 1980 and 2001 have been informed that they may be at an increased risk of infection with variant Creutzfeldt-Jakob disease (vCJD). We describe a study to detect disease-associated, protease-resistant prion protein (PrPres) in 17 neurologically aysmptomatic patients with haemophilia considered to be at increased risk of vCJD. Materials from 11 autopsy and seven biopsy cases were analysed for PrPres. The tissues available from each case were variable, ranging from a single biopsy sample to a wide range of autopsy tissues. A single specimen from the spleen of one autopsy case gave a strong positive result on repeated testing for PrPres by Western blot analysis. This tissue came from a 73-year-old male patient with no history of neurological disease, who was heterozygous (methionine/valine) at codon 129 in the prion protein gene. He had received over 9000 units of factor VIII concentrate prepared from plasma pools known to include donations from a vCJD-infected donor, and some 400 000 units not known to include donations from vCJD-infected donors. He had also received 14 units of red blood cells and had undergone several surgical and invasive endoscopic procedures. Estimates of the relative risks of exposure through diet, surgery, endoscopy, blood transfusion and receipt of UK-sourced plasma products suggest that by far the most likely route of infection in this patient was receipt of UK plasma products.

Item Type: Article
Keywords: haemophilia, plasma, prion protein, spleen, vCJD, creutzfeldt-jakob-disease, prion protein, blood-transfusion, tissues, transmission, prevalence, sheep, vcjd
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 20070383
Web of Science ID: 274941200012
URI: http://researchonline.lshtm.ac.uk/id/eprint/3968

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