Sporadic Creutzfeldt–Jakob disease and surgery: A case–control study using community controls
Abstract
BACKGROUND: The cause of sporadic Creutzfeldt-Jakob disease (CJD) is unknown. Previous studies found a link with a history of surgery but had methodologic problems. OBJECTIVE: To help elucidate medical and associated risk factors for sporadic CJD as part of the 1993 to 1995 European Union collaborative studies of CJD. METHODS: Medical and associated risk factors from 326 patients with sporadic CJD, taken from population-based studies performed between 1993 and 1995 in France, Germany, the Netherlands, and the UK, were compared with 326 community controls recruited by telephone in 2000. RESULTS: A history of surgery was significantly associated with the risk of sporadic CJD (odds ratio [OR]: 1.8; 95% CI: 1.2 to 2.6), which was not dependent on the number of surgical procedures, and was stronger in females (OR: 2.5; 95% CI: 1.5 to 4.0). Gynecologic (OR: 1.5; 95% CI: 1.0 to 2.3) and "other" operations (any operation other than neurologic, eye, ear, gallbladder, gastrointestinal, and gynecologic operations, tonsillectomy, and appendectomy) (OR: 1.5; 95% CI: 1.1 to 2.1) were associated with risk of CJD. Tonsillectomy (OR: 0.3; 95% CI: 0.2 to 0.5) and appendectomy (OR: 0.6; 95% CI: 0.4 to 0.8) were observed less frequently in cases. An increased risk was also found with a history of ear piercing in females (OR: 1.6; 95% CI: 1.1 to 2.5) and psychiatric visit(s) (OR: 2.6; 95% CI: 1.5 to 4.3). CONCLUSIONS: These results support the hypothesis that cases of sporadic CJD may result from hitherto unrecognized surgical contamination events. However, because of the limits of the study design, the rarity of the disease, and the potential for bias, the results should be interpreted with caution.
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There is a slight risk of prion transmission by instruments used on patients with undiagnosed prion disease.
“the (slight) risk of prion transmission by instruments used on patients with undiagnosed prion disease106”
From Pathogenic protein seeding in Alzheimer disease and other neurodegenerative disorders (2011) · cites this paper as [106]
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Pathogenic protein seeding in Alzheimer disease and other neurodegenerative disorders
Jucker, M., & Walker, L. C. (2011) · Annals of Neurology · doi:10.1002/ana.22615 · Cited by 622 · see citing works
“Nevertheless, when considered alongside the (slight) risk of prion transmission by instruments used on patients with undiagnosed prion disease 106 , the hypothetical risk that non-prion proteopathies might be similarly induced suggests a need for more research into the epidemiology of such…”
BackgroundPhenotypic variability in human prion diseases
Ironside, J. W., Ritchie, D. L., & Head, M. W. (2005) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.2005.00697.x · Cited by 58 · see citing works
- Authors
- Ward, H. J. T., Everington, D., Croes, E. A., Alperovitch, A., Delasnerie–Lauprêtre, N., Zerr, I., Poser, S., & van Duijn, C. M.
- Affiliations
- Inserm (FR)
- From the National CJD Surveillance Unit (Dr. Ward and D. Everington), Western General Hospital, Edinburgh, UK; Department of Epidemiology and Biostatistics (Drs. van Duijn and Croes), Erasmus University Medical Centre Rotterdam, the Netherlands; U360 INSERM (Drs. Alperovitch and Delasnerie–Lauprêtre), Hôpital de la Salpetrière, Paris, France; and Neurologische Klinik (Drs. Zerr and Poser), Georg-August Universität, Göttingen, Germany.
- ORCID
- Venue
- Neurology
- Published
- 2002-08-27
- Volume
- 59
- Issue
- 4
- Pages
- 543-548
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2119230352
- Cited by
- 95
- References
- 23
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2019: 1 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 5
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- GRO (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Prion Diseases and Protein Misfolding
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Amyloidosis: Diagnosis, Treatment, Outcomes
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- sporadic Creutzfeldt-Jakob disease, surgical risk factors, history of surgery, gynecologic surgery, tonsillectomy, appendectomy, ear piercing, psychiatric visits, surgical contamination, sex differences
- MeSH terms
- Aged, Female, France, Germany, United Kingdom, Humans, Creutzfeldt-Jakob Syndrome, Male, Middle Aged, Netherlands, Registries, Risk Factors, Sex Factors, Surgical Procedures, Operative, Odds Ratio, Case-Control Studies, Sex Distribution, Risk Assessment
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