Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, fatal brain disease. Sporadic CJD (sCJD) is the most common subtype without genetic cause. There have been no reports on biologically related family members who died from sCJD.
Here, we report two first cousins (common paternal grandfather) who died of sCJD.
Patient 1 was a 58-year-old white woman who became unusually quiet with mild aphasia since previous year, and then developed intermittent confusion, which progressed rapidly within 2-3 months, followed by myoclonus, tremor, tactile hallucinations, and gait abnormality. Encephalography (EEG) showed periodic spike and slow waves at a frequency of about 0.5Hz with a left fronto-temporal predominance throughout the recording and evidence of moderately severe diffuse encephalopathy. Cerebral Spinal Fluid (CSF) studies were unremarkable. Patient 2 was a man who was 2 years older than patient 1. At age of 63, he developed forgetfulness and mild gait abnormality, followed by visual hallucinations and myoclonus with startle, which progressed to catastrophic cognitive decline. EEG had no generalized or lateralized epileptiform discharges. CSF showed normal 14-3-3 and cytology. Both patients’ Magnet Resonance Imaging (MRI) demonstrated patterns highly suggestive of CJD. Patients died 6 and 4 months after their initial symptoms, respectively. Genetic study failed to find pathogenic mutations of the prion protein gene, and autopsy confirmed their diagnosis of sCJD MM1 and VV1-2, respectively.
Both patients were born in Grand Rapids, Michigan. Patient 2 moved to Florida in teenage years, and only visited Michigan in summers. They never lived or traveled together, only met occasionally at family reunion.