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Iatrogenic Creutzfeldt-Jakob disease

New Jersey State Department of Health, Special Child Health Services, Trenton, NJ.

Over the past 2 years, Creutzfeldt-Jakob disease (CJD) has affected several patients who received cadaver pituitary-derived growth hormone (pit-hGH) and one patient who received a cadaveric dura mater graft. The risk of iatrogenic transmission of CJD has long been recognized, but until recently, the low prevalence of the disorder and minimal use of therapeutic products derived from human tissues may have limited the risk. From 1963 to 1985, approximately 10,000 children received pit-hGH. These patients, exposed to pooled products potentially contaminated with the CJD agent, may have significantly increased the number of individuals whose blood and tissues could transmit CJD. This possibility as well as data on the pathophysiology of CJD and scrapie, a related disease of animals, should guide the development of practices that would limit iatrogenic spread of CJD.

Address correspondence and reprint requests to Dr. Rappaport, New Jersey State Department of Health, Special Child Health Services, CN 364, Trenton, NJ 08625.

A major portion of this work was done while the author was a medical officer in the US Food and Drug Administration.

Received April 16, 1987. Accepted for publication in final form May 29, 1987.