Journal
PLOS ONE
Volume 9, Issue 10, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0109412
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Funding
- EU Research Commission [QLRG3-CT-2002-81223]
- NEUROPRION
- Spanish Centro de Investigaciones en enfermedades Neurologicas [CIEN C03-06]
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED) networks
- Carlos III National Health Institute
- Karolinska Institute
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Introduction: Sporadic Creutzfeldt-Jakob disease (sCJD) might be transmitted by surgery. The purpose of this study was to investigate potential susceptibility to sCJD from surgery at juvenile age and in early adulthood. Methods: From Danish and Swedish national registries we identified 167 definite and probable sCJD cases with onset from 1987 through 2003, and 835 age-, sex- and residence-matched controls along with their surgical histories. Main, anatomically or etiologically classified surgical procedures followed by a >= 20-year lag were analyzed using logistic regression, and stratified by age at first-registered surgical discharge. Results: The risk of having a diagnosis of CJD depended strongly on age at first surgery with odds ratio (OR) of 12.80 (95% CI 2.56-64.0) in patients <30 years, 3.04 (95% 1.26-7.33) in 30-39 years, and 1.75 (95% CI 0.89-3.45) in >= 40 years, for anatomically classified surgical procedures. Similar figures were obtained for etiologically classified surgical procedures. Conclusions: Risk of surgical-acquired sCJD depends on age at exposure; this pattern is similar to age-specific profiles reported for CJD accidentally transmitted by human pituitary-derived growth hormone and susceptibility curves for variant CJD estimated after adjustment for dietary exposure to bovine spongiform encephalopathy. There might be an age-at-exposure-related susceptibility to acquire all CJD forms, including sCJD from routine surgery.
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