The pathological changes of Alzheimer’s disease (AD) begin 10–20 years before clinical onset, and it is therefore desirable to identify effective methods for early diagnosis. The nasal mucosa is a target tissue for measuring AD-related biomarkers because the olfactory nerve is the only cranial nerve that is exposed to the external environment. We describe an autopsy case of rapidly advanced juvenile AD (JAD), focusing on the olfactory system. The formation of senile plaques, neurofibrillary tangles (NFTs), and neuropil threads was examined in the temporal cortex, hippocampus, olfactory bulb, and olfactory and respiratory epithelia in the bilateral olfactory clefts. Neurodegenerative changes in the olfactory and respiratory epithelia and the pathological deposition of amyloid β42 (Aβ42) and phosphorylated tau were also examined. As a result, senile plaques, NFTs, and neuropil threads were found in the temporal cortex, hippocampus, and olfactory bulb. NFTs were also found in the olfactory epithelium. Degenerated olfactory cells and their axons stained positive for phosphorylated tau. Supporting cells in the degenerated olfactory epithelium stained positive for Aβ42. In conclusion, pathological biomarkers of AD were expressed in the degenerated olfactory epithelium of this JAD patient. This observation suggests that nasal samples may be useful for the diagnosis of AD.

阿尔茨海默病 (AD) 的病理变化开始于临床发病前 10-20 年，因此需要寻找有效的早期诊断方法。鼻黏膜是测量 AD 相关生物标志物的靶组织，因为嗅觉神经是唯一暴露于外部环境的颅神经。我们描述了一个快速晚期青少年 AD (JAD) 的尸检案例，重点关注嗅觉系统。在颞叶皮层、海马、嗅球以及双侧嗅裂的嗅觉和呼吸上皮细胞中检查了老年斑、神经原纤维缠结 (NFT) 和神经纤维丝的形成。还检查了嗅觉和呼吸上皮细胞的神经退行性变化以及淀粉样蛋白 β42 (Aβ42) 和磷酸化 tau 的病理沉积。因此，在颞叶皮层、海马体和嗅球中发现了老年斑、NFTs 和神经纤维丝。在嗅觉上皮中也发现了 NFT。退化的嗅觉细胞及其轴突对磷酸化 tau 染色呈阳性。退化的嗅上皮中的支持细胞对 Aβ42 染色呈阳性。总之，AD 的病理生物标志物在该 JAD 患者的退化嗅上皮中表达。这一观察结果表明，鼻样本可能有助于诊断 AD。总之，AD 的病理生物标志物在该 JAD 患者的退化嗅上皮中表达。这一观察结果表明，鼻样本可能有助于诊断 AD。总之，AD 的病理生物标志物在该 JAD 患者的退化嗅上皮中表达。这一观察结果表明，鼻样本可能有助于诊断 AD。