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要旨 症例は67歳女性。進行する失語症状で当科へ入院した。明らかな家族歴,既往歴はなく,頭部MRIでは,T2強調画像や拡散強調画像で左側優位の大脳皮質に沿って広範囲な高信号領域を認めた。脳波で周期性同期性放電はみられなかったが,プリオン蛋白遺伝子解析では多型はcodon129Met/Met,codon219Glu/Gluでcodon180に点変異(Val→Ile)を認めたため家族性Creutzfeldt-Jakob病(CJD)と診断した。Codon180点変異CJDの頭部MRIではT2強調,FLAIR,拡散強調画像で特徴的な変化がみられ,臨床症状とともに診断的価値があると考えられた。
A 67-year-old woman was admitted to our hospital with progressive aphasia. There was no family history of similar diseases or any history of dura transplantation. Cranial magnetic resonance imaging(MRI) showed high signal areas in the temporal and parietal cortex predominantly on the left side on both T2-weighted images and on diffusion-weighted images. There were no periodic synchronous discharges observed on the electroencephalogram. As prion protein gene codon 180 point mutation(Val/Ile)was detected, we diagnosed her as having Creutzfeldt-Jakob disease(CJD). The characteristics of CJD of this type differ from those of sporadic CJD. To date, few papers on CJD with point mutation of codon 180 have been reported from Japan.
(Received : August 3, 2004)
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