{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:28:02Z","timestamp":1786976882331,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["2016T86"],"award-info":[{"award-number":["2016T86"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp; Dementia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Cerebral amyloid angiopathy (CAA) causes stroke and cognitive decline. The recently identified iatrogenic CAA subtype (iCAA) is thought to be transmitted through medical procedures involving cadaveric human material and potentially neurosurgical instruments or blood transfusions. This raises ethical questions concerning disclosure of iCAA. We consider ethical arguments concerning three disclosure\u2010related questions. Should clinicians disclose their suspicion of iCAA to patients presenting with CAA and a history of relevant exposure? Should clinicians recommend the additional tests needed for iCAA diagnosis? Should clinicians proactively identify and notify asymptomatic at\u2010risk individuals who are unaware of their risk? We conclude that disclosure of the iCAA\u2010diagnosis and communication of diagnostic uncertainties are warranted, based on professional responsibility to facilitate autonomous decision\u2010making, despite limited clinical benefits. While certain diagnoses are impossible, recommending additional diagnostics can provide diagnostic support and exclude other causes. Notification of known exposure\u2010confirmed, asymptomatic, at\u2010risk individuals seems warranted; however, proactive identification remains challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>iCAA may result from A\u00df transmission via medical treatments.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We discuss three clinically relevant disclosure\u2010related ethical questions that arise due to the uncertainty surrounding the discovery of iCAA.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We focus on disclosing to patients with suspected iCAA the recommendation of additional diagnostics and proactive identification and notification of asymptomatic persons at risk.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This analysis supports clinicians in their decision to disclose a presumed iCAA diagnosis and when informing patients about additional CAA diagnostics.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Our findings serve as a reference tool for handling disclosure of future discoveries of presumed iatrogenesis (e.g., that of iatrogenic Alzheimer's disease).<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70431","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T08:46:53Z","timestamp":1752828413000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ethical considerations of disclosure of iatrogenic cerebral amyloid angiopathy"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1429-6853","authenticated-orcid":false,"given":"Kanishk","family":"Kaushik","sequence":"first","affiliation":[{"name":"Department of Neurology Leiden University Medical Centre (LUMC)  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen M.","family":"Eijkholt","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Health Law LUMC  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke","family":"de Graeff","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Health Law LUMC  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gargi","family":"Banerjee","sequence":"additional","affiliation":[{"name":"MRC Prion Unit Institute of Prion Diseases at University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Werring","sequence":"additional","affiliation":[{"name":"Stroke Research Centre Department of Brain Repair and Rehabilitation UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela M.","family":"Terwindt","sequence":"additional","affiliation":[{"name":"Department of Neurology Leiden University Medical Centre (LUMC)  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellis S.","family":"van Etten","sequence":"additional","affiliation":[{"name":"Department of Neurology Leiden University Medical Centre (LUMC)  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke J. H.","family":"Wermer","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG)  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(23)00114\u2010x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(22)00208\u20103"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102022\u2010328792"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.122.041690"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.14445"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11064\u2010022\u201003566\u20104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awad193"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1806.120116"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010023\u201002729\u20102"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/b978\u20100\u2010444\u201063233\u20103.00003\u20108"},{"key":"e_1_2_11_12_1","volume-title":"The Stanford Encyclopedia of Philosophy","author":"Christman J","year":"2020"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bioe.13106"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010220052"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007578.pub2"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11019\u2010018\u201009883\u20102"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/nmd.0000000000000729"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/1089\u20102680.5.2.100"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12309"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493020974464"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930231203133"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326\u20105377.2004.tb05863.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12631"},{"issue":"10","key":"e_1_2_11_24_1","first-page":"1389","article-title":"Notifying patients exposed to blood products associated with Creutzfeldt\u2010Jakob disease: integrating science, legal duties and ethical mandates","volume":"157","author":"Caulfield T","year":"1997","journal-title":"CMAJ"},{"issue":"7","key":"e_1_2_11_25_1","first-page":"771","article-title":"Notifying patients exposed to blood products associated with Creutzfeldt\u2010Jakob disease: theoretical risk for real people","volume":"159","author":"King SM","year":"1998","journal-title":"CMAJ"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328646"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.01.015"},{"key":"e_1_2_11_28_1","unstructured":"UK Government.Guidance document duty of candour.UK Government; Updated 5 Oct 2020. 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