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KMID : 1100220160150040170
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Dementia and Neurocognitive Disorders
2016 Volume.15 No. 4 p.170 ~ p.173
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Neurosyphilis Mimicking Creutzfeldt-Jakob Disease
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Jang Jae-Hoon
Park Jeong-Hoon
Eo Yong-Jun
Kim Seong-Heon
Choi Kyung-Ho
Yi Sang-Hak
Park Young-Ho
Kim Sang-Yun
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Abstract
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Background : As rapidly progressive dementia (RPD), general paresis and Creutzfeldt-Jakob disease (CJD) may have overlapping clinical presentation due to a wide variety of clinical manifestations.
Case Report : A 57-year-old man presented with rapid progressive cognitive decline, behavioral change, ataxic gait, tremor and pyramidal signs for 3 months. In addition to these multiple systemic involvements, positive result for the cerebrospinal fluid (CSF) 14-3-3 protein tentatively diagnosed him as probable CJD. However, due to increased serum rapid plasma reagin, venereal disease research laboratory, and fluorescent treponemal antibody-absorption reactivity in CSF, the final diagnosis was changed to general paresis.
Conclusions : A patient with RPD needs to be carefully considered for differential diagnosis, among a long list of diseases. It is important to rule out CJD, which is the most frequent in RPD and is a fatal disease with no cure. Diagnostic criteria or marker of CJD, such as 14-3-3 protein, may be inconclusive, and a typical pattern in diffusion-weighted imaging is important to rule out other reversible diseases.
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KEYWORD
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neurosyphilis, general paresis, rapidly progressive dementia, Creutzfeldt-Jakob disease
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