Creutzfeldt-Jakob Disease after Dental Procedure Along with the Initial Manifestations of Psychiatric Disorder: A Case Report
Introduction: Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures.
Case Report: The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI.
Discussion: Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.
2. Atalay FÖ, Tolunay Ş, Özgün G, Bekar A, Zarifoğlu M. Creutzfeldt-Jakob Disease: Report of Four Cases and Review of the Literature/Creutzfeldt-Jakob Hastalığı: Dört Olgunun Sunumu ve Literatürün Gözden Geçirilmesi. Turkish Journal of Pathology. 2015;31(2):148-52.
3. Brown P, Farrell M. A practical approach to avoiding iatrogenic Creutzfeldt-Jakob disease (CJD) from invasive instruments. Infect Control Hosp Epidemiol. 2015;36(7):844-8.
4. Knight R. Infectious and Sporadic Prion Diseases. Prog Mol Biol Transl Sci. 2017;150:293-318.
5. Hemachander SS, Khaja S, Kaza S. Occupational hazard with “PRIONS”–in autopsy workers. Journal of Indian Academy of Forensic Medicine. 2008;30(1):26-8.
6. Centers fo Disease Control and Prevention(CDC),Saving Lives,Protecting People,2018.Available from https://www.cdc.gov/prions/vcjd/diagnostic-criteria.html.
7. Alcalde-Cabero E, Almazan-Isla J, Brandel JP, Breithaupt M, Catarino J, Collins S, et al. Health professions and risk of sporadic Creutzfeldt-Jakob disease, 1965 to 2010. Euro Surveill. 2012;17(15).
8. Sushma B, Gugwad S, Pavaskar R, Malik SA. Prions in dentistry: A need to be concerned and known. J Oral Maxillofac Pathol. 2016;20(1):111-4.
9. Thomas JG, Chenoweth CE, Sullivan SE. Iatrogenic Creutzfeldt-Jakob disease via surgical instruments. J Clin Neurosci. 2013;20(9):1207-12.
10. Bonda DJ, Manjila S, Mehndiratta P, Khan F, Miller BR, Onwuzulike K, et al. Human prion diseases: surgical lessons learned from iatrogenic prion transmission. Neurosurg Focus. 2016;41(1):E10.
11. Brown P, Brandel JP, Sato T, Nakamura Y, MacKenzie J, Will RG, et al. Iatrogenic Creutzfeldt-Jakob disease, final assessment. Emerg Infect Dis. 2012;18(6):901-7.
12. Xiao X, Yuan J, Qing L, Cali I, Mikol J, Delisle MB, et al. Comparative Study of Prions in Iatrogenic and Sporadic Creutzfeldt-Jakob Disease. J Clin Cell Immunol. 2014;5(4).
13. Azarpazhooh A, Fillery ED. Prion disease: the implications for dentistry. J Endod. 2008;34(10):1158-66.
14. Head MW, Ritchie D, McLoughlin V, Ironside JW. Investigation of PrPres in dental tissues in variant CJD. Br Dent J. 2003;195(6):339-43; discussion 1.
15. Bali Z, Bali RK, Nagrath S. Prion diseases: risks, characteristics, and infection control considerations in dentistry. J Investig Clin Dent. 2011;2(4):236-40.
16. Bourvis N, Boelle PY, Cesbron JY, Valleron AJ. Risk assessment of transmission of sporadic Creutzfeldt-Jakob disease in endodontic practice in absence of adequate prion inactivation. PLoS One. 2007;2(12):e1330.
17. Molesworth AM, Smith AJ, Everington D, Ord F, Watt P, Will RG, et al. Risk factors for variant Creutzfeldt-Jakob disease in dental practice: a case-control study. Br Dent J. 2012;213(11):E19.
|Issue||Vol 16 No 1 (2021)|
|Creutzfeldt-Jakob Disease Dental Procedures Psychiatric Manifestation|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|