RT Journal Article
SR Electronic
T1 Iatrogenic cerebral amyloid angiopathy: an emerging clinical phenomenon
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 693
OP 700
DO 10.1136/jnnp-2022-328792
VO 93
IS 7
A1 Banerjee, Gargi
A1 Samra, Kiran
A1 Adams, Matthew E
A1 Jaunmuktane, Zane
A1 Parry-Jones, Adrian Robert
A1 Grieve, Joan
A1 Toma, Ahmed K
A1 Farmer, Simon F
A1 Sylvester, Richard
A1 Houlden, Henry
A1 Rudge, Peter
A1 Mead, Simon
A1 Brandner, Sebastian
A1 Schott, Jonathan M
A1 Collinge, John
A1 Werring, David J
YR 2022
UL http://jnnp.bmj.com/content/93/7/693.abstract
AB In the last 6 years, following the first pathological description of presumed amyloid-beta (Aβ) transmission in humans (in 2015) and subsequent experimental confirmation (in 2018), clinical cases of iatrogenic cerebral amyloid angiopathy (CAA)—attributed to the transmission of Aβ seeds—have been increasingly recognised and reported. This newly described form of CAA is associated with early disease onset (typically in the third to fifth decade), and often presents with intracerebral haemorrhage, but also seizures and cognitive impairment. Although assumed to be rare, it is important that clinicians remain vigilant for potential cases, particularly as the optimal management, prognosis, true incidence and public health implications remain unknown. This review summarises our current understanding of the clinical spectrum of iatrogenic CAA and provides a diagnostic framework for clinicians. We provide clinical details for three patients with pathological evidence of iatrogenic CAA and present a summary of the published cases to date (n=20), identified following a systematic review. Our aims are: (1) To describe the clinical features of iatrogenic CAA, highlighting important similarities and differences between iatrogenic and sporadic CAA; and (2) To discuss potential approaches for investigation and diagnosis, including suggested diagnostic criteria for iatrogenic CAA.