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. Normotensive, pulse bpm, she had universal alopecia, cyanosis and pale alternating in the extremities, growing nails of the right hand and scars on her back and face.
Rncefalopatia is recommended to reduce the dose of steroids over several months. The most common abnormality is diffuse increased signal in the white substance 2.
The majority of patients return to their normal neurological state. In this case, the Hashimoto’s encephalopathy diagnosis was made based on the exclusion of other toxic-metabolic encephalopathic and neurological diseases of infectious or vascular origin, and on the detection of high concentrations of anti-TPO antibodies.
Services on Demand Journal. The dose of thyroxine was reduced to mcg. We describe the case of a patient with Hashimoto’s encephalopathy who showed clinical manifestations similar to those of Creutzfeldt-Jakob disease. SPECT can be normal but usually shows focal hypoperfusion 8. The prevalence has been estimated to be 2. The magnetic resonance imaging MRI of the brain showed small changes that were not significant, such as the presence of hypersignal focus in the corona radiata and bilaterally semioval center Fig hashikoto.
Hashimoto’s encephalopathy mimicking Creutzfeldt-Jakob disease: Since then, Hashimoto’s encephalopathy has been recognized as a rare condition associated to Hashimooto thyroiditis and to the presence of high concentrations of antithyroid antibodies, unlike those described in myxedema and in thyrotoxicosis 2.
Hashimoto’s encephalopathyalso known as steroid responsive encephalopathy associated with autoimmune thyroiditis SREATis a neurological condition characterized by encephalopathythyroid autoimmunity, and good clinical response to steroids. She was maintained on oral prednisolone.
In some cases, Hashimoto’s encephalopathy can show rapidly progressive dementia, myoclonus, and electroencephalographic changes with periodic recurrence of the triphasic complexes similar enecfalopatia those of Creutzfeldt-Jakob disease, which makes a differential diagnosis essential to both pathologies 4.
High titres of anti-TPO are common markers of an auto-immune process but it is unlikely that they have a pathogenic role 9. A relapsing encephalopathy occurring in association with Hashimoto’s thyroiditiswith high titers of anti-thyroid antibodies.
The thyroid-stimulating hormone TSH was slightly elevated at 7. The electroencephalogram EEG at admission was abnormal, with slow, monomorphic, occasionally sharp, triphasic, enxefalopatia theta-delta frequency ranges from 2 to 3 Hz, intermittent, bilateral waves, predominantly in the temporoparietal regions Fig 2A.
Oligoclonal bands were absent. There followed a period of three years with difficulties at school.
The patients met the clinical criteria for Creutzfeldt-Jakob disease and were notified 8. There are EEG changes in most cases, mainly general slowing 2,8. Post-mortem studies of some individuals have shown lymphocytic vasculitis of venules and veins in the brain-stem and a diffuse gliosis involving gray matter more than white matter.
As mentioned above, autoantibodies to alpha- enolase associated with Hashimoto’s encephalopathy have thus far been the most hypothesized mechanism of injury. Clinically, the condition may present one or more symptoms.
Encephalomyelitis Acute disseminated Myalgic Meningoencephalitis.
Over scientific articles on Hashimoto’s encephalopathy were published between and Focal Generalised Status epilepticus Myoclonic epilepsy. The condition of the encefalolatia worsened with persecutory delusions, visual hallucinations, gait disturbance, tremor of the extremities, muscle spasms, and fluctuations in the level of consciousness. The levels of triiodothyronine T3 and free thyroxine T4 L were within normal limits.
Therapeutic options for relapsing cases or as an alternative to steroids include azathioprine, cyclophosfamide, mycophenolate mofetil, methotrexate, IV immunoglobulin and plasmapheresis, alone or in combination 8. InBrain et al. We believe that this pathology is misdiagnosed, therefore, tests detecting the presence of anti-thyroid antibodies are recommended in a clinical presentation of encephalopathy of subacute onset encefalopahia rapidly progressive dementia associated with myoclonus and triphasic complexes in the EEG, when the ethiology is not identified.
Neuroendocrinology Brain disorders Autoimmune diseases Steroid-responsive inflammatory conditions.
Hashimoto’s encephalopathy – Wikipedia
The dose of steroid was gradually reduced. There was a reduction in anti-TPO which co-related with the clinical picture. Antithyroid antibodies in the CSF: Japan, and Depannient of Anatomy and Biology. It was suggested that the hypocampus, hypothalamus and hair follicles form a molecular target for auto-immunity, the so-called ‘triple H’ syndrome 6. CASE A female patient, years-old, Caucasian, widow, born in Rio de Janeiro, developed a clinical presentation of daily sadness, discouragement, decreased appetite, insomnia, and cognitive decline.
J Neurol Sci ; The most common findings are diffuse or generalized slowing or frontal intermittent rhythmic delta activity. A recent study by Martins et al. It is sometimes referred hxshimoto as a neuroendocrine disorder, although the condition’s relationship to the endocrine system is widely disputed.
Creutzfeldt-Jakob disease has a progressive and inexorably fatal course, as opposed to Hashimoto’s encephalopathy, which has a fluctuating course and excellent response to treatment with corticosteroids. Archived from the original on All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. She had three pregnancies with normal gestation, last 9 years ago. We related the case of a patient with Hashimoto’s encephalopathy and clinical features similar to those of Creutzfeldt-Jakob disease.
She was stable, suggesting a hypothalamic dysfunction. Long-term treatment of Hashimoto’s encephalopathy. Views Haxhimoto Edit View history. Most reported cases occur during the patient’s fifth decade of life.