Hashimoto encephalopathy (HE) is an uncommon syndrome associated with Hashimoto thyroiditis Cantón A, de Fàbregas O, Tintoré M, et al. Request PDF on ResearchGate | On Jun 1, , Paloma Bacarizo and others published Encefalopatía de Hashimoto en un paciente de 20 años. CLINICAL/SCIENTIFIC NOTE. Hashimoto’s encephalopathy. Encefalite de Hashimoto. Renata Telles Rudge de AquinoI; Eduardo Genaro MutarelliII.
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Migraine Familial hemiplegic Cluster Tension. How to cite this article.
Anti-thyroperoxidase antibodies anti-TPO was 1. At present, it is unclear whether antithyroid antibodies represent an immune epiphenomenon in a subset of patients with encephalopathic processes or they are really associated with pathogenic mechanisms of the disorder.
Besides behavioral problems and cognitive decline, there may be fluctuating symptoms, tremor, transitory aphasia, myoclonus, ataxia, convulsions, sleep abnormalities, motor or sensory deficits and psychosis. Two clinical forms have been described: At admission, she was sleepy, disoriented, showing myoclonus, paratonia on the back of the head and arms, her deep reflexes were symmetrical with plantar flexion response and suction and grasping reflexes were present. Services on Demand Journal.
The symptoms were recurrent and reversible and were not associated with thyroid dysfunction 1. Over scientific articles on Hashimoto’s encephalopathy were published between and Retrieved from ” https: Episodes of sinus tachycardia of bpm followed, with normal cardiac investigations.
Hepato-toxicity encefalopata to the interruption of azathioprine in this case. Some patients need to stay on low doses or a new course of high dose of prednisolone is necessary 2.
Encefalopatia de Hashimoto
However, the final diagnosis is obtained through a neuropathological exam 9. Clinical manifestations of HE may include encephalopathic features such as seizures, behavioral and psychiatric manifestations, movement disorders, and coma. Because most patients respond to steroids or immunosuppressant treatment, this condition is now also referred to as steroid -responsive encephalopathy.
The responsiveness of HE to steroids or other therapies such as plasmapheresis supports the hypothesis that this is a disorder that involves immune pathogenic mechanisms. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Gashimoto occur predominantly in women 4: SPECT can be normal but usually shows focal hypoperfusion 8.
The majority of patients return to their normal neurological state. The clinical improvement can occur on the first day, like in this case, but generally occurs within a week and up to 6 weeks 8.
Hashimoto’s encephalopathy with clinical features similar to those of Creutzfeldt-Jakob disease
The rest of the physical examination was normal. The condition of the patient worsened with persecutory delusions, visual hallucinations, gait disturbance, tremor of the extremities, muscle encefalopaatia, and fluctuations in the level of consciousness. The most common abnormality is diffuse increased signal in the white substance 2.
In encefalopatoa cases, Hashimoto’s encephalopathy can show rapidly progressive dementia, myoclonus, and electroencephalographic changes with periodic recurrence of the triphasic complexes similar to those of Creutzfeldt-Jakob disease, which makes a differential diagnosis essential to both pathologies 4. Some aspects warrant particular attention: A possible vasculitic process has been shown in biopsy studies 7. The main change in the CSF is the increase in total protein, that was mild in this case, and rarely some lymphocytic pleocytosis 2,4.
Alopecia is associated with polyglandular autoimmunity. Brain herniation Reye’s Hepatic encephalopathy Toxic encephalopathy Hashimoto’s encephalopathy. The levels of triiodothyronine T3 and free thyroxine T4 L were within normal limits. Proteomic analysis of human brain identifies alpha-enolase as a novel autoantigen in Hashimoto’s encephalopathy.
Failure of some patients to respond to this first eencefalopatia treatment has produced a variety of alternative treatments including azathioprinecyclophosphamidechloroquinemethotrexateperiodic intravenous immunoglobulin and plasma exchange.
Serology, cultures and diagnostic imaging did not indicate an infectious process. The clinical presentation may suggest a diagnosis of Creutzfeldt-Jakob enceffalopatia. She was stable, suggesting a hypothalamic dysfunction.