Serum anti‐thyroid antibodies in Hashimoto’s encephalopathy: A never‐ending story

2020 ◽  
Vol 11 (3) ◽  
pp. 198-199
Author(s):  
Tommaso Ercoli ◽  
Federica Maria Genitori ◽  
Giovanni Defazio ◽  
Antonella Muroni
Keyword(s):  
Thyroid Antibodies ◽  
Hashimoto’S Encephalopathy

scholarly journals Paroxysmal Amnesia Attacks due to Hashimoto’s Encephalopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Pelin Nar Senol ◽  
Aylin Bican Demir ◽  
Ibrahim Bora ◽  
Mustafa Bakar
Keyword(s):  
Cognitive Impairment ◽  
Antiepileptic Drug ◽  
Rare Disease ◽  
Psychiatric Symptoms ◽  
Thyroid Antibodies ◽  
Immunomodulatory Agents ◽  
Clinical Appearance ◽  
Hashimoto’S Encephalopathy ◽  
Eeg Abnormalities ◽  
Cerebral Involvement

Hashimoto’s encephalopathy is a rare disease which is thought to be autoimmune and steroid responsive. The syndrome is characterized by cognitive impairment, encephalopathy, psychiatric symptoms, and seizures associated with increased level of anti-thyroid antibodies. The exact pathophysiology underlying cerebral involvement is still lesser known. Although symptoms suggest a nonlesional encephalopathy in most of the cases, sometimes the clinical appearance can be subtle and may not respond to immunosuppressants or immunomodulatory agents. Here we report a case who presented with drowsiness and amnestic complaints associated with paroxysmal electroencephalography (EEG) abnormalities which could be treated only with an antiepileptic drug.

scholarly journals Hashimoto’s Encephalopathy Presenting with Unusual Behavioural Disturbances in an Adolescent Girl

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Murugan Selvaraj Karthik ◽  
Kulothungan Nandhini ◽  
Viswanath Subashini ◽  
Ramasamy Balakrishnan
Keyword(s):  
Clinical Presentation ◽  
Autoimmune Disorder ◽  
High Serum ◽  
Thyroid Antibodies ◽  
Antipsychotic Medications ◽  
Hashimoto’S Encephalopathy ◽  
Neuropsychiatric Manifestations ◽  
Euthyroid Status ◽  
Very High

Hashimoto’s encephalopathy (HE) is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE. Our consultant neurologist confirmed the diagnosis and she was started on injection of methylprednisolone 750 mg OD. Since patient started showing clinical improvement, her antipsychotic medications were tapered off. On follow-up, patient has recovered and is functioning well. Since HE is a diagnosis of exclusion, very high anti-TPO antibodies and good response to steroids supported the diagnosis of HE in this patient after excluding other etiological possibilities. This case has been reported because the clinical presentation was predominantly neurobehavioural manifestations which is uncommon with HE.

scholarly journals Hashimoto’s encephalopathy in a patient with septal panniculitis: a case report

Reumatismo ◽  
2018 ◽  
Vol 70 (4) ◽  
pp. 268-269
Author(s):  
C. Cosso ◽  
M. Ghio ◽  
M. Cutolo
Keyword(s):  
Case Report ◽  
Autoimmune Thyroiditis ◽  
Behavioral Changes ◽  
Glucocorticoid Therapy ◽  
Thyroid Antibodies ◽  
Mental Confusion ◽  
Hashimoto’S Encephalopathy

Hashimoto’s encephalopathy (HE) is an autoimmune form of encephalopathy, associated with autoimmune thyroiditis. Its prevalence is estimated to be 2:100,000. HE is characterized by behavioral changes, mental confusion, dysarthria, ataxia, psychosis, paranoia, convulsions, hallucinations, headache and hyperthermia. Elevated thyroid antibodies are necessary for diagnosis and the disease responds dramatically to glucocorticoid therapy. We describe a patient with HE and panniculitis, an association reported twice in the literature.

scholarly journals Steroid-Responsive Epilepsia Partialis Continua with Anti-Thyroid Antibodies: A Spectrum of Hashimoto's Encephalopathy

2014 ◽  
Vol 6 (2) ◽  
pp. 166-170 ◽  
Author(s):  
Hiroki Masuda ◽  
Masahiro Mori ◽  
Shoichi Ito ◽  
Toshiyuki Yagishita ◽  
Satoshi Kuwabara
Keyword(s):  
Thyroid Antibodies ◽  
Epilepsia Partialis Continua ◽  
Hashimoto’S Encephalopathy

scholarly journals Psychosis Crisis Associated with Thyrotoxicosis due to Graves’ Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Lilibet Urias-Uribe ◽  
Emmanuel Valdez-Solis ◽  
Claudia González-Milán ◽  
Claudia Ramírez-Rentería ◽  
Aldo Ferreira-Hermosillo
Keyword(s):  
Cerebrospinal Fluid ◽  
Electroconvulsive Therapy ◽  
Psychiatric Illness ◽  
Psychiatric Symptoms ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Thyroid Antibodies ◽  
Hashimoto’S Encephalopathy

We present the case of a patient with previous psychiatric illness, acutely exacerbated by thyroid storm due to Graves’ disease, in whom treatment with antipsychotics induced catatonia. These associations are extremely rare and may be confused with Hashimoto’s encephalopathy, especially in the presence of anti-thyroid antibodies in cerebrospinal fluid. The treatment consists in the control of the triggering disease (in this case the resolution of the thyrotoxicosis) and the use of benzodiazepines. However, in some cases, the resolution of psychiatric symptoms is partial and may require the use of electroconvulsive therapy.

Hashimoto's Encephalopathy

2020 ◽  
pp. 126-140
Keyword(s):  
Thyroid Hormone ◽  
Oral Prednisone ◽  
Hormone Treatment ◽  
High Dose ◽  
Thyroid Antibodies ◽  
Depression And Anxiety ◽  
Hashimoto’S Encephalopathy ◽  
Methyl Prednisolone ◽  
Neuro Inflammation

Hashimoto's encephalopathy is a relapsing encephalopathy occurring in association with Hashimoto's thyroiditis (HT) with high titers of anti-thyroid antibodies. The mechanism of pathogenesis is unknown. Auto-antibodies to α-enolase have been found to be associated with Hashimoto's encephalopathy. Recently, the crucial role of neuro-inflammation in the development of psychological disorders including depression and anxiety has received more attention. Because the majority of patients with Hashimoto's encephalopathy respond to steroids or immuno-suppressant treatment, this condition is now also referred to as “steroid-responsive encephalopathy.” Initial treatment is usually with oral prednisone (50–150 mg/day) or high-dose IV methyl-Prednisolone (1 g/day) for 3-7 days. Thyroid hormone treatment is also included if required. This chapter explores Hashimoto's encephalopathy.

scholarly journals Hashimoto's Encephalopathy Masquerading as Rapidly Progressive Dementia and Extrapyramidal Failure

2022 ◽  
Author(s):  
Yasser Aladdin ◽  
Bader Shirah
Keyword(s):  
Autoimmune Thyroiditis ◽  
Delayed Diagnosis ◽  
Thyroid Antibodies ◽  
Cerebral Damage ◽  
Serological Testing ◽  
Progressive Dementia ◽  
Rare Presentation ◽  
Hashimoto’S Encephalopathy ◽  
Immune Mediated ◽  
Underlying Pathogenesis

AbstractHashimoto's encephalopathy is a rare immune-mediated disorder characterized by subacute encephalopathy with elevated thyroid antibodies. Hashimoto's encephalopathy is also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis. We report a rare presentation of Hashimoto's encephalopathy presenting with acute neuropsychiatric disturbances, rapidly progressive dementia, seizures, and extrapyramidal failure. Neuroimaging revealed multifocal vasculitides of major cerebral vessels that support the autoimmune vasculitic theory as the underlying pathogenesis for Hashimoto's encephalopathy. Unfortunately, permanent irreversible cerebral damage has already ensued before her presentation to our center, which rendered steroid therapy ineffective. Serological testing for Hashimoto's thyroiditis must be in the investigation of all rapidly progressive dementias as early diagnosis and timely management of autoimmune thyroiditis may salvage sizable and eloquent cerebral tissues. The rarity of the condition should not preclude the investigation of Hashimoto's disease even in the presence of normal levels of thyroid hormones. Delayed diagnosis may result in irreversibly catastrophic encephalopathy in patients who once presented with potentially curable dementia.

scholarly journals A case report on Hashimoto’s encephalopathy: an autoimmune neuroendocrine disorder

2020 ◽  
Vol 8 (1) ◽  
pp. 131
Author(s):  
Abarna Lakshmi R. ◽  
Rajganesh Ravichandran ◽  
Jaya Shree D. ◽  
Raveena P. B. ◽  
Nikhil Cherian Sam ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Thyroid Function Test ◽  
Thyroid Antibodies ◽  
Good Recovery ◽  
Resonance Imaging ◽  
High Concentration ◽  
Hashimoto’S Encephalopathy ◽  
Function Test ◽  
Magnetic Resonance Imaging Mri ◽  
Electroencephalogram Eeg

Hashimoto’s encephalopathy (HE) is a rare neuroendocrine disorder with high titers of the thyroid antibodies. HE is more common to women than in men with a ratio of approximately 5:1. The estimated prevalence of HE was 2 per 100,000 people. We present a case of Hashimoto’s encephalopathy in a 24-year-old male patient known case of hypothyroidism admitted with the complaints of unconsciousness, and further developed seizure during admission. Brain magnetic resonance imaging (MRI) was normal, electroencephalogram (EEG) revealed slow diffusion, and the serum thyroid function test showed a high concentration of anti-thyroid antibodies. The patient had a good recovery after the management with steroid therapy.  

Other Proven and Putative Autoimmune Disorders of the CNS

2017 ◽  
Author(s):  
Eoin P. Flanagan ◽  
Richard J. Caselli
Keyword(s):  
Cognitive Decline ◽  
Potassium Channel ◽  
Cancer Patients ◽  
General Term ◽  
Autoimmune Disorders ◽  
Thyroid Antibodies ◽  
Serological Evidence ◽  
Voltage Gated ◽  
Hashimoto’S Encephalopathy ◽  
Autoimmune Encephalopathy

The historical term “Hashimoto’s encephalopathy” describes a serologically diverse spectrum of autoimmune encephalopathies that tend to be highly steroid responsive and unassociated with cancer. Patients typically present with subacute cognitive decline and serological evidence of autoimmunity that includes but is not limited to thyroid antibodies. An inflammatory spinal fluid and, in a subset of patients, MRI signal abnormalities are supportive. Patients often respond promptly to corticosteroids but relapses are typical. The continued discovery of novel neural-specific-autoantibodies such as voltage-gated-potassium-channel-autoantibodies associated with autoimmune encephalopathies highlights why the term “Hashimoto’s” is misleading. The authors advocate the more general term “autoimmune encephalopathy.”

scholarly journals Hashimoto’s Encephalopathy Revealed by Hypochondriacal Delusion: A Case Report Involving a Male Patient

2020 ◽  
Vol 14 (5) ◽  
pp. 155798832095508
Author(s):  
Badii Amamou ◽  
Imen Ben Saida ◽  
Amjed Ben Haouala ◽  
Ahmed Mhalla ◽  
Ferid Zaafrane ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Male Patient ◽  
Clinical Presentation ◽  
Autoimmune Disorder ◽  
High Serum ◽  
Thyroid Antibodies ◽  
Resonance Imaging ◽  
Diagnostic Challenge ◽  
Hashimoto’S Encephalopathy ◽  
History Of

Hashimoto’s encephalopathy (HE) is a rare autoimmune disorder. It associates encephalopathy with autoimmune thyroiditis, presenting abnormal elevations of thyroid antibodies. It is more common in females. It can present with various symptoms, including seizures, myoclonus, psychosis, hallucinations, and mood disturbances. Hypochondriacal delusion is an unusual clinical presentation of this disorder. The authors report a case of HE in a male patient whose clinical presentation was dominated by hypochondriacal delusion. The absence of response to antipsychotics, high serum antithyroid peroxidase antibodiesof about 199 UI/ml, the normality of magnetic resonance imaging, and improvement with corticosteroids confirmed the diagnosis. This neuroendocrine disorder is often misdiagnosed and it represents a diagnostic challenge for clinicians. It should be considered in patients presenting a refractory or an atypical neuropsychiatric disorder and having a family history of autoimmune disease.

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