15-10-2024 | Dementia | Letter to the Editors
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A case of argyrophilic grain disease with an initial clinical diagnosis of Parkinson’s disease
Authors:
Akira Arakawa, Shigeo Murayama, Satoru Morimoto, Tomoyasu Matsubara, Renpei Sengoku, Masashi Kameyama, Aya M. Tokumaru, Airi Tarutani, Masato Hasegawa, Atsushi Iwata, Tatsushi Toda, Yuko Saito
Published in:
Journal of Neurology
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Excerpt
Argyrophilic grain disease (AGD) is an age associated four-repeat tauopathy that contributes to cognitive decline in older individuals with the accumulation of argyrophilic grains (AGs) in the limbic system [
1‐
3]. The diagnosis of dementia with grains (DG) is reserved for when AGD is the only pathology encountered in a case of dementia [
3,
4]. On neuropathological examination, AGs are detected as comma-like or spindle-shaped granular structures on the Gallyas silver stain [
1], now immunostaining with antibodies against phosphorylated tau and isoformic 4-repeat tau. AGD is accompanied by ballooned neurons, pretangles, bush-like or granular/fuzzy astrocytes [
5], and coiled bodies in the oligodendroglia [
2,
3]. Saito et al. proposed a stage of AGD, starting in the ambient gyrus (Stage I), spreading to the temporal pole and hippocampus (Stage II), and finally reaching the cingulate gyrus and basal forebrain (Stage III), and contributing to clinical dementia [
3]. Asymmetry in neuroimages [
6], symptomatology [
7] and postmortem neuropathology are hallmark features of AGD. …