28.12.2004

New variant Creutzfeldt-Jakob disease and bovine pituitary growth hormone

Ghazot and colleagues describe a case of new variant Creutzfeldt-Jakob disease (nvCJD) in a French patient. [1] His illness began in February, 1994 (he died in January, 1996, after his disease had lasted 23 months).

In the UK, there has been only one patient in whom clinical onset occurred earlier, in January, 1994. (2) The fact that onset in the French case of nvCJD occurred earlier than in all but one of the cases reported in the UK is surprising, even if one considers that France was one of the biggest markets for UK beef. A report for the French National Assembly on the "mad cow" crisis, (3) which revealed that the French patient, a mechanic by profession, was also a devoted body-builder, may provide a clue.

Cadaveric human growth hormone has been used to increase muscle strength and reduce fat mass in weight lifters and body-builders. This practice is still going on in some eastern European countries, (4) although, apparently, not in France. However, since 1951, a drug well-known in France, "somatotrophine", the bovine equivalent of human growth hormone, has been prescribed for "tissue repairs". In common with human growth hormone, it has a lipolytic and a protein anabolic effect (but has no effect on growth). This drug, reimbursed by the French Securite Sociale and administered by subcutaneous or intramuscular injections (100 units daily, for 8 days) was, like most of the other drugs of bovine origin, banned, as a precautionary measure, in July, 1992.

It is possible that the one case of nvCJD reported in France might be an iatrogenic case resulting from the injections of bovine somatotrophin contaminated with bovine spongiform encephalopathy. Onset in February, 1994, is compatible with an inoculation having occurred during the late 1980s (the shortest incubation period with contaminated human growth hormone is 4 years).

1. Chazot G, Broussolle E, Lapras CL, et al. New variant of Creutzfeldt-Jakob disease in a 26-year-old French man. Lancet 1996; 347: 1181.
2. Cousens SN, Vynnycky E, Zeidler M, et al. Predicting the CJD epidemic in humans. Nature 1997; 385: 197-98.
3. Guilhem E, Mattei JF. De la "vache folle" a la "vache emissaire". Tome II. Auditions. No 3291. Paris: Assemblee Nationale, 1997: 23.
4. Deyssig R, Frisch H. Self-administration of cadaveric growth hormone in athletes. Lancet 1993; 341: 768-69.

Lancet. 1998 Jan 10;351(9096):112-3.

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