An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications

Abstract We report an atypical case of Creutzfeldt-Jakob Disease (CJD) mimicking Frontotemporal Dementia (FTD) in a 68-year-old male. The patient initially presented with an anxious-depressive syndrome, progressing over 29 months to include dysexecutive syndrome, stereotyped speech, inertia, social...

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Main Authors: Carlo Manco, Delia Righi, Barbara Pucci, Bruno Damiano, Andrea Mignarri, Nicola De Stefano, Domenico Plantone
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Geriatrics
Online Access:https://doi.org/10.1186/s12877-025-06290-0
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author Carlo Manco
Delia Righi
Barbara Pucci
Bruno Damiano
Andrea Mignarri
Nicola De Stefano
Domenico Plantone
author_facet Carlo Manco
Delia Righi
Barbara Pucci
Bruno Damiano
Andrea Mignarri
Nicola De Stefano
Domenico Plantone
author_sort Carlo Manco
collection DOAJ
description Abstract We report an atypical case of Creutzfeldt-Jakob Disease (CJD) mimicking Frontotemporal Dementia (FTD) in a 68-year-old male. The patient initially presented with an anxious-depressive syndrome, progressing over 29 months to include dysexecutive syndrome, stereotyped speech, inertia, social withdrawal, verbal fluency impairments, and marked dyspraxia. Diagnostic imaging revealed signal alterations on MRI, while CSF analysis showed elevated T-TAU, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) levels. A second-generation RT-QuIC (SG-RT-QuIC) confirmed prion disease, with genetic testing identifying a codon 129 MV polymorphism and a deletion in the third octapeptide repeat. This case highlights the importance of integrating advanced diagnostic tools, such as SG-RT-QuIC and comprehensive genotyping, in evaluating atypical presentations of CJD. Early elevated GFAP levels highlight the usefulness of considering neuroinflammatory markers in slowly progressive forms of CJD.
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issn 1471-2318
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publishDate 2025-08-01
publisher BMC
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series BMC Geriatrics
spelling doaj-art-86089a0e7e964c3082a1f36af1f695cd2025-08-20T04:02:55ZengBMCBMC Geriatrics1471-23182025-08-012511610.1186/s12877-025-06290-0An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implicationsCarlo Manco0Delia Righi1Barbara Pucci2Bruno Damiano3Andrea Mignarri4Nicola De Stefano5Domenico Plantone6Department of Medicine, Surgery and Neuroscience, University of SienaDepartment of Medicine, Surgery and Neuroscience, University of SienaAzienda Ospedaliero-Universitaria SeneseDepartment of Medicine, Surgery and Neuroscience, University of SienaAzienda USL Toscana Sud EstDepartment of Medicine, Surgery and Neuroscience, University of SienaDepartment of Medicine, Surgery and Neuroscience, University of SienaAbstract We report an atypical case of Creutzfeldt-Jakob Disease (CJD) mimicking Frontotemporal Dementia (FTD) in a 68-year-old male. The patient initially presented with an anxious-depressive syndrome, progressing over 29 months to include dysexecutive syndrome, stereotyped speech, inertia, social withdrawal, verbal fluency impairments, and marked dyspraxia. Diagnostic imaging revealed signal alterations on MRI, while CSF analysis showed elevated T-TAU, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) levels. A second-generation RT-QuIC (SG-RT-QuIC) confirmed prion disease, with genetic testing identifying a codon 129 MV polymorphism and a deletion in the third octapeptide repeat. This case highlights the importance of integrating advanced diagnostic tools, such as SG-RT-QuIC and comprehensive genotyping, in evaluating atypical presentations of CJD. Early elevated GFAP levels highlight the usefulness of considering neuroinflammatory markers in slowly progressive forms of CJD.https://doi.org/10.1186/s12877-025-06290-0
spellingShingle Carlo Manco
Delia Righi
Barbara Pucci
Bruno Damiano
Andrea Mignarri
Nicola De Stefano
Domenico Plantone
An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications
BMC Geriatrics
title An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications
title_full An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications
title_fullStr An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications
title_full_unstemmed An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications
title_short An atypical case of Creutzfeldt-Jakob disease mimicking frontotemporal dementia: genotypic influence and clinical implications
title_sort atypical case of creutzfeldt jakob disease mimicking frontotemporal dementia genotypic influence and clinical implications
url https://doi.org/10.1186/s12877-025-06290-0
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