クロイツフェルト・ヤコブ病患者の抜歯経験
−プリオン病とその汚染防止対策について−

高橋由美子 １,２）　浦出雅裕 ２）　川端啓太 ３）　立花久大 ３）

Rare experience of tooth extractions of a patient with Creutzfeldt-Jakob Disease
−Decontamination Procedures for Prion Desease−

Yumiko Takahashi １,２）， MasahiroUrade ２）， Keita Kawabata ３）， Hisao Tachibana ３）

　Creutzfeldt-Jakob disease(CJD) occurs worldwide and usually becomes evident as dementia, followed by loss of coordination and death in one or two years. It sporadically affects one person per million, and typically the elderly people(sporadic CJD). In the United Kingdom in 1996, a report on patients with new-variant Creutzfeldt-Jakob disease(new-variant CJD) raised the strong possibility that bovine spongiform encephalopathy can be transmitted to humans. To identify patients with such new-variant CJD in Japan, a nationwide survey was commissioned by the Ministry of Health and Welfare and conducted by the Japan CJD Surveillance Group in 1996. The survey identified no new-variant CJD but revealed a major outbreak of CJD transmitted through dural grafts in Japan
(iatrogenic CJD). 
We report a case of a 72-year-old female suffering from terminal sporadic CJD from whom we extracted teeth. Through her clinical course of CJD, general considerations of prion diseases, tissue infectivity and decontamination procedures are discussed in this report.

Key Words：sporadic CJD （孤発性 CJD）, prion disease （プリオン病）, tissue infectivity （組織感染性）,
decontamination procedures （汚染防止対策） 

１） 柏原赤十字病院歯科口腔外科 （主任：高橋由美子医長） 
Department of Dentistry and Oral Surgery, Kaibara Red-Cross Hospital (Chief: Dr.Yumiko Takahashi)
２） 兵庫医科大学歯科口腔外科学講座 （主任：浦出雅裕教授） 
Department of Dentistry and Oral Surgery, Hyogo College of Medicine (Chief : Prof. Masahiro Urade)
3） 兵庫医科大学総合内科学講座 （神経、 SCU 科） （主任：芳川裕男教授） 
Division of Neurology and Stroke Care Unit, Department of Internal Medicine, Hyogo College of Medicine
(Chief : Prof. Hiroo Yoshikawa)
　　〔2004年２月２日受付、 2004年３月26日受理〕