Walsh & Hoyt: Iatrogenic Creutzfeldt-Jakob Disease

The first documented occurrence of an iatrogenic prion disease occurred in sheep that were vaccinated against looping illness with formalin-treated bovine lymphoid tissue. Iatrogenic CJD (iCJD) was first reported in 1974 in a patient who had received a corneal transplant; the recipient developed ataxia 18 months postoperatively and died after disease duration of 8 months. It subsequently was found that animal corneas contain significant levels of PrPC and thus have significant potential to transmit CJD. In addition to its ability to be transmitted via corneal tissue, iCJD can be transmitted through postmortem pituitary tissue used for extraction of human growth hormone (GH) or gonadotropins, insertion of processed human cadaveric dural or pericardial grafts, organ transplantation, and use of inadequately sterilized neurosurgical instruments.