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Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis

Hashimoto's encephalopathy (HE) is a steroid-responsive autoimmune encephalopathy associated with Hashimoto thyroiditis. We herein report a case of HE manifesting “smoldering” limbic encephalitis with persisting symptoms and abnormalities on examinations. Although our patient experienced partia...

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Detalles Bibliográficos
Autores principales: Nagano, Masahiro, Kobayashi, Katsuya, Yamada-Otani, Mayumi, Kuzuya, Akira, Matsumoto, Riki, Oita, Jiro, Yoneda, Makoto, Ikeda, Akio, Takahashi, Ryosuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522399/
https://www.ncbi.nlm.nih.gov/pubmed/30982805
http://dx.doi.org/10.2169/internalmedicine.1289-18
Descripción
Sumario:Hashimoto's encephalopathy (HE) is a steroid-responsive autoimmune encephalopathy associated with Hashimoto thyroiditis. We herein report a case of HE manifesting “smoldering” limbic encephalitis with persisting symptoms and abnormalities on examinations. Although our patient experienced partial clinical remission after treatment, hippocampal hypermetabolism on [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and subclinical seizures on video electroencephalography persisted. Hypermetabolism on FDG-PET was improved by additional prednisolone therapy. Thus, as with other autoimmune limbic encephalitis cases, HE can take a course of “smoldering” encephalitis. FDG-PET and electroencephalogram findings can reflect the disease activity degree in such patients, although with certain neurophysiological and biochemical distinctions.