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[A case report of Creutzfeldt-Jakob disease associated with myocarditis]
H Yoshikawa1, K Fukuda, Y Nakamura
1Department of Medicine, Wakayama Medical College.
Insights
This case report details Creutzfeldt-Jakob disease (CJD) in a 77-year-old woman, complicated by acute myocarditis. The cardiac symptoms were transient, suggesting a potential link between the CJD infectious agent and myocarditis.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Background:
- Creutzfeldt-Jakob disease (CJD) is a rare, fatal neurodegenerative prion disease.
- Myocarditis is inflammation of the heart muscle, often caused by viral infections.
Observation:
- A 77-year-old woman presented with rapidly progressive visual disturbance, myoclonus, and dementia, suggestive of CJD.
- Electroencephalogram showed periodic synchronous discharges, supporting the CJD diagnosis.
- The patient developed acute myocarditis with transient electrocardiogram ST-T changes and left ventricular hypokinesis.
Findings:
- Cardiac enzyme levels were mildly elevated.
- No significant viral antibody titers were detected, ruling out common viral causes of myocarditis.
- This case presents a potential association between the CJD infectious agent and the development of myocarditis.
Implications:
- This case may represent the first documented instance of Creutzfeldt-Jakob disease complicated by myocarditis.
- Further research is warranted to explore the potential direct or indirect mechanisms linking CJD and cardiac inflammation.
- Understanding this association could inform diagnostic and therapeutic strategies for CJD patients with cardiac involvement.
Abstract:
We have encountered a case of Creutzfeldt-Jakob disease associated with myocarditis. A 77 year-old woman was admitted to a hospital with complaints of rapidly progressive visual disturbance, myoclonus and dementia. Electroencephalogram revealed a periodic synchronous discharge and Creutzfeldt-Jakob disease was suspected. Then she moved to our hospital, because acute myocarditis was combined with ST-T changes on electrocardiogram, and generalized hypokinetic motion of the left ventricle on echocardiogram. The abnormal findings in electrocardiography and echocardiography were transient. Blood levels of enzymes derived from the myocardium were slightly elevated. We could not find a distinct increase in the titer of neutralizing antibody to various viruses. In this case, the cause of myocarditis may have been associated with the infectious agent of Creutzfeldt-Jakob disease. This report might be the first one with a case of Creutzfeldt-Jakob disease complicated with myocarditis.