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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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:
Case Report
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
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author Nagano, Masahiro
Kobayashi, Katsuya
Yamada-Otani, Mayumi
Kuzuya, Akira
Matsumoto, Riki
Oita, Jiro
Yoneda, Makoto
Ikeda, Akio
Takahashi, Ryosuke
author_facet Nagano, Masahiro
Kobayashi, Katsuya
Yamada-Otani, Mayumi
Kuzuya, Akira
Matsumoto, Riki
Oita, Jiro
Yoneda, Makoto
Ikeda, Akio
Takahashi, Ryosuke
author_sort Nagano, Masahiro
collection PubMed
description 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.
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spelling pubmed-65223992019-05-20 Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis Nagano, Masahiro Kobayashi, Katsuya Yamada-Otani, Mayumi Kuzuya, Akira Matsumoto, Riki Oita, Jiro Yoneda, Makoto Ikeda, Akio Takahashi, Ryosuke Intern Med Case Report 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. The Japanese Society of Internal Medicine 2019-04-15 /pmc/articles/PMC6522399/ /pubmed/30982805 http://dx.doi.org/10.2169/internalmedicine.1289-18 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Nagano, Masahiro
Kobayashi, Katsuya
Yamada-Otani, Mayumi
Kuzuya, Akira
Matsumoto, Riki
Oita, Jiro
Yoneda, Makoto
Ikeda, Akio
Takahashi, Ryosuke
Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis
title Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis
title_full Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis
title_fullStr Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis
title_full_unstemmed Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis
title_short Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis
title_sort hashimoto's encephalopathy presenting with smoldering limbic encephalitis
topic Case Report
url 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
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