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Academia Mexicana de Neurología, A.C.

2017, Number 3

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Rev Mex Neuroci 2017; 18 (3)

Encephalopathy associated to dysthyroidism with positive peroxidase antibodies. Case report and literature review

Cabrera-Espinosa ES, Enríquez-Coronel G, Carrillo-Torres D, Clemente-Pérez RA

Language: Spanish
References: 47
Page: 79-87
PDF size: 574.94 Kb.


ABSTRACT

Introduction: Hashimoto’s encephalopathy is a condition associated with dysthyroidism and other autoimmune diseases. The pathophysiology is unclear and clinically the disease is characterized by neurological and psychiatric alterations in absence of brain infection. Antithyroid antibodies are high and imaging studies may be normal. Corticosteroid therapy is the treatment of choice.
Case report: A 36-year-old woman with monoparesis, behavior and personality changes and hyperthyroidism. Lumbar puncture was done and infectious, metabolic and neoplastic encephalopathy causes were ruled out. MRI skull was requested, it reports compatible images with various brain abscesses of undetermined origin. Considering a probable Hashimoto encephalopathy, anti-peroxidase and thyroglobulin antibodies were requested, detecting high titers. Corticosteroids and immunoglobulin scheme were started with a poor response to the treatment.
Conclusions: This case associated Hashimoto’s encephalopathy with hyperthyroidism, a rare association reported in the literature. It was suspected a CNS primary vasculitis due to high values of complement; however, brain biopsy was not performed to define a more accurate diagnosis.


REFERENCES

  1. Tamagno G, Federspil G, Murialdo G. Clinical and diagnostic aspects of encephalopathy associated to autoimmune thyroid disease (or Hashimoto’s encephalopathy). Intern Emerg Med 2006; 1: 15-23.

  2. Lee SW, Stacy Donlon DO, Caplan JP. Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) or Hashimoto’s encephalopathy: a case and review. Psychosomatics 2011; 52: 99-108.

  3. Brain L, Jellinek EH, Ball K. Hashimoto’s disease and encephalopathy. Lancet 1966; 2: 512-514.

  4. Ferracci F, Bertiato G, Moretto G. Hashimoto’s encephalopathy: epidemiologic data and pathogenetic considerations. J Neurol Sci 2004; 217: 165-168.

  5. Chong JY, Rowland LP, Utiger RD. Hashimoto encephalopathy: syndrome or myth? Arch Neurol 2003; 60: 164-171.

  6. Salpietro V, Mankad K, Polizzi A, Sugawara Y, Granata F, David E et al. Pediatric Hashimoto’s encephalopathy with peripheral nervous system involvement. Pediatr Int 2014; 56: 413-416.

  7. Hu J, Zhang M, Mu Y. Fatal acute encephalopathy in a young man with Graves’ disease. Endocrine 2014; 45: 158-159.

  8. Castillo P, Woodruff B, Caselli R, Vernino S, Lucchinetti C, Swanson J, et al. Steroid-responsive encephalopathy associated with autoimmune thyroiditis. Arch Neurol 2006; 63: 197-202.

  9. Tamagno G, Celik Y, Simó R, Dihné M, Kimura K, Gelosa G, et al. Encephalopathy associated with autoimmune thyroid disease in patients with Graves’ disease: clinical manifestations, follow-up, and outcomes. BMC Neurol 2010; 10: 27.

  10. Abeledo A, Valera C, Poo P, Ortez C, Nascimento A, Casano P. Down syndrome and Hashimoto’s encephalitis. Rev Med Int Sindr Down 2010; 14: 10-13.

  11. Zamora M, Labarta L, Mallor T, Villacampa V, et al. Encefalitis de Hashimoto, a propósito de un caso. Med Intensiva 2013; 38: 522-523.

  12. Imperiale D, Labate C, Testi R, Romito A, Taraglio S. Clinical and neuropathological findings in Hashimoto’s encephalopathy: a case report. Neurol Sci 2014; 35: 327-329.

  13. Mocellin R, Walterfang M, Velakoulis D. Hashimoto’s encephalo-pathy: Epidemiology, pathogenesis and management. CNS Drugs 2007; 21: 799-811.

  14. Huang X, Yu Y, Zhang H, Liu J, Sun Y, Chang M, Cui C. Hashimoto encephalopathy associated with hyperthyroidism: A case report. Exp Ther Med 2014; 8: 515-518.

  15. Schiess N, Pardo CA. Hashimoto’s encephalopathy. Ann N Y Acad Sci 2008; 1142: 254-265.

  16. Nolte KW, Unbehaun A, Sieker H, Kloss TM, Paulus W. Hashimoto encephalopathy: a brainstem vasculitis. Neurology 2000; 54: 769-770.

  17. Mijajlovic M, Mirkovic M, Dackovic J, Zidverc-Trajkovic J, Sternic N. Clinical manifestations, diagnostic criteria and therapy of Hashimoto’s encephalopathy: report of two cases. J Neurol Sci 2010; 288: 194-196.

  18. Goh KK, Chiu YH, Shen WW. Hashimoto’s encephalopathy mimicking presenile dementia. Gen Hosp Psychiatry 2014; 36: 360.

  19. Tang Y, Chu C, Lin MT, Wei G, Zhang X, Da Y et al. Hashimoto’s encephalopathy mimicking spinocerebellar ataxia. J Neurol 2011; 258: 1705-1707.

  20. Tsai M-H, Lee LH, Chen SD, Lu CH, Chen MT, Chuang YC. Complex partial status epilepticus as a manifestationvof Hashimoto’s encephalopathy. Seizure 2007; 16: 713-716.

  21. Salazar R, Mehta C, Zaher N, Miller D. Opsoclonus as a manifestation of Hashimoto’s encephalopathy. J Clin Neurosci 2012; 19: 1465-1466.

  22. Inoue K, Kitamura J, Yoneda M, Imamura E, Tokinobu H. Hashimoto’s encephalopathy presenting with micrographia as a typical feature of parkinsonism. Neurol Sci 2012; 33: 395-397.

  23. Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baumgartner R, Hess CW. Encephalopathy associated with Hashimoto thyroiditis: diagnosis and treatment. J Neurol 1996; 243: 585-593.

  24. Watemberg N, Greenstein D, Levine A. Encephalopathy associated with hashimoto thyroiditis: pediatric perspective. J Child Neurol 2006; 21: 1-5.

  25. Arya R, Anand V, Chansoria M. Hashimoto encephalopathy presenting as progressive myoclonus epilepsy syndrome. Eur J Paediatr Neurol 2013; 17: 102-104.

  26. de Holanda NC, de Lima DD, Cavalcanti TB, Lucena CS, Bandeira F. Hashimoto’s encephalopathy: systematic review of the literature and an additional case. J Neuropsychiatry Clin Neurosci 2011; 23: 384-390.

  27. Marshall GA, Doyle JJ. Long-term treatment of Hashimoto’s encephalopathy. J Neuropsychiatry Clin Neurosci 2006; 18: 14-20.

  28. Ferracci F, Moretto G, Candeago RM, Cimini N, Conte F, Gentile M, et al. Antithyroid antibodies in the CSF: their role in the pathogenesis of Hashimoto’s encephalopathy. Neurology 2003; 60: 712- 714.

  29. Blanchin S, Coffin C, Viader F, Ruf J, Carayon P, Potier F, et al. Anti-thyroperoxidase antibodies from patients with Hashimoto’s encephalopathy bind to cerebellar astrocytes. J Neuroimmunol 2007; 192: 13-20.

  30. Katoh N, Yoshida T, Shimojima Y, Gono T, Matsuda M, Yoneda M et al. An 85-year-old case with Hashimoto’s encephalopathy, showing spontaneous complete remission. Intern Med 2007; 46: 1613- 1616.

  31. Hernández Echebarría LE, Saiz A, Graus F, Tejada J, García JM, Clavera B, et al. Detection of 14-3-3 protein in the CSF of a patient with Hashimoto’s encephalopathy. Neurology 2000; 54: 1539-1540.

  32. Fujii A, Yoneda M, Ito T, Yamamura O, Satomi S, Higa H, et al. Autoantibodies against the amino terminal of alpha-enolasa are useful diagnostic marker of Hashimoto’s encephalopathy. J Neuroimmunol 2005: 162: 130-136.

  33. Song YM, Seo DW, Chang GY. MR findings in Hashimoto encephalopathy. AJNR Am J Neuroradiol 2004; 25: 807-808.

  34. Chen N, Qin W, Wei C, Wang X, Li K. Time course of Hashimoto’s encephalopathy revealed by MRI: report of two cases. J Neurol Sci 2011; 300: 169-172.

  35. Bohnen NI, Parnell KJ, Harper CM. Reversible MRI findings in a patient with Hashimoto’s encephalopathy. Neurology 1997; 49: 246-247

  36. Zettinig G, Asenbaum S, Fueger BJ, Hofmann A, Diemling M, Mittlboeck M, et al. Increased prevalence of sublinical brain perfusion abnormalities in patients with autoimmune thyroiditis: evidence of Hashimoto’s encephalitis? Clin Endocrinol (Oxf) 2003; 59: 637-643.

  37. Piga M, Serra A, Deiana L, Loi GL, Satta L, Di Liberto M, et al. Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis. Eur J Nucl Med Mol Imaging 2004; 31: 1639-1644

  38. Pari E, Rinaldi F, Premi E, Codella M, Rao R, Paghera B et al. A follow-up ¹8F-FDG brain PET study in a case of Hashimoto’s encephalopathy causing drug-resistant status epilepticus treated with plasmapheresis. J Neurol 2014; 261 :663-667.

  39. Shaw PJ, Walls TJ, Newman PK, Cleland PG. Hashimoto’s encephalopathy a steroid responsive disorder associated with high anti-thyroid antibody titers. Report of 5 cases. Neurology 1991; 41: 228-233.

  40. Peschen-Rosin R, Schabet M, Dichgans J. Manifestation of Hashimoto’s encephalopathy years before onset of thyroid disease. Eur Neurol 1999; 41: 79-84.

  41. Chaudhuri A, Behan PO. The clinical spectrum, diagnosis, pathogenesis and treatment of Hashimoto’s encephalopathy (recurrent acute disseminated encephalomyelitis). Curr Med Chem 2003; 10: 1945-1953.

  42. Boers PM, Colebatch JG. Hashimoto’s encephalopathy responding to plasmapheresis. J Neurol Neurosurg Psychiatr 2001; 70: 132.

  43. Chaigne B, Beaufils B, Jouan Y, Magnant J, Maillot F, Constans T, et al. Encéphalopathie d’Hashimoto. Rev Med Interne 2012; 33: 390-395.

  44. Stienen MN, Haghikia A, Dambach H, Thöne J, Wiemann M, Gold R, et al. Antiinflammatory effects of the anticonvulsant drug levetiracetam on electrophysiological properties of astroglia are mediated via TGFβ1 regulation. Br J Pharmacol Jan 2011; 162: 491-507.

  45. Wong LC, Freeburg JD, Montouris GD, Hohler AD. Two patients with Hashimoto’s encephalopathy and uncontrolled diabetes successfully treated with levetiracetam. J Neurol Sci 2015; 348: 251-252.

  46. Tzakas P, Sit SW. Progressive impairment of cognition and motor function: Hashimoto encephalopathy CMAJ 2011; 183: E495-7.

  47. Mercier E. L’encéphalopathie d’Hashimoto en réanimation: quando doit-on l’évoquer?. Réanimation 2013; 22: 642-647.




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