A rare and usually fatal disease of the brain characterized by progressive dementia and gradual loss of muscle control, CJD occurs most often in middle age.

Dutch researchers report on the case of a man who developed CJD 38 years after receiving human derived growth hormone.

A 47 year old man was given only a low dose as part of a diagnostic procedure, rather than being given full treatment, which may explain why the incubation period lasted so long -- the longest on record -- say the authors.

He had delayed growth as a child, for which he underwent testing using a form of human derived growth hormone to exclude growth hormone deficiency when he was 9. The source of the hormone used is not known, but it is highly unlikely that this man would have developed CJD by chance, say the authors.

His symptoms began with numbness in both arms, which progressed to difficulty in walking and involuntary movements. After eight months, he was admitted to hospital and died five months later. CJD was confirmed at post mortem examination.

The first Dutch patient with CJD associated with human growth hormone died in 1990, but she had been treated with deep muscle injections over several years on various occasions.

There are 564 other registered recipients of the hormone in the Netherlands who were treated before 1985, none of whom are currently suspected of having CJD.

But the authors conclude: ". . .This case indicates that still more patients with iatrogenic CJD can be expected in the coming years," adding, "another implication of our study is that CJD can develop even after a low dose of human growth hormone."

(Reference: Creutzfeldt-Jakob disease 38 years after diagnostic use of human growth hormone, E A Croes, G Roks, G H Jansen, P C G Nijssen, C M van Duijn, 2002; 72: 792-3)

(Editor's Note: Full text of this Short Report is available at this URL.)


[Contact: British Medical Association]

23-May-2002