Creutzfeldt-Jakob disease

• Transmission of infective agent through contaminated growth hormone preparations and possibly through food.
• The possible potentiating role of pesticides and other foreign chemicals, and nutritional deficiencies remains to be investigated.
• Medications containing bismuth may cause a similar syndrome.

A patient given a bismuth preparation for 15 months developed an encephalopathy resembling Creutzfeldt-Jakob disease but recovered when the bismuth was discontinued. Bismuth preparations are commonly used in the treatment of gastritis. Von Bose MJ et al: Encephalopathy resembling Creutzfeldt-Jakob disease following oral, prescribed doses of bismuth nitrate. Br J Psychiatry 158:278-80, 1991.