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LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male
Hashimoto encephalopathy (HE) is a term used to describe an encephalopathy of presumed autoimmune origin characterized by high titers of antithyroid peroxidase antibodies, an essential feature of this disorder. Pertinent laboratory findings include an elevated serum level of antithyroid peroxidase a...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625549/ http://dx.doi.org/10.1210/jendso/bvac150.1545 |
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author | Canales, Shellsea Portillo Loria, Gloriana Madrigal Sanchez Valenzuela, Maria C Fernandez Felix, Daniel A Castano, Yennifer Gil Sharma, Sapna Arias Morales, Carlos E |
author_facet | Canales, Shellsea Portillo Loria, Gloriana Madrigal Sanchez Valenzuela, Maria C Fernandez Felix, Daniel A Castano, Yennifer Gil Sharma, Sapna Arias Morales, Carlos E |
author_sort | Canales, Shellsea Portillo |
collection | PubMed |
description | Hashimoto encephalopathy (HE) is a term used to describe an encephalopathy of presumed autoimmune origin characterized by high titers of antithyroid peroxidase antibodies, an essential feature of this disorder. Pertinent laboratory findings include an elevated serum level of antithyroid peroxidase antibody (TPOAb) and/or antithyroglobulin antibody (TgAb) and negative autoimmune markers of encephalitis in cerebrospinal fluid (CSF). The analysis of CSF may show increased cellularity due to lymphocytic pleocytosis. However, there is no clear relationship between the severity of neurologic symptoms and the type or serum concentration of antibodies. Approximately two-thirds of patients of HE will experience seizures. Patients can present with a recurrence/remission or a diffuse, progressive pattern characterized by slowly progressive cognitive impairment with dementia, confusion, or hallucinations. We present a rare case of Hashimoto's encephalopathy associated with hyperthyroidism in a 61-year-old man evaluated for left facial droop and right upper extremity weakness, successfully treated with corticosteroids and methimazole. We conclude that the diagnosis of HE should be suspected early and be on the differential in patients who present with encephalopathy, which workup shows positive anti-thyroid antibodies and CSF with lymphocytosis. Treatment for meningitis or other life-threatening conditions should never be postponed, as HE is a diagnosis of exclusion that usually requires an extensive laboratory and diagnostic workup. Early diagnosis has an excellent outcome once treatment is started as it is a steroid-responsive encephalopathy associated with autoimmune thyroiditis. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m. |
format | Online Article Text |
id | pubmed-9625549 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-96255492022-11-14 LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male Canales, Shellsea Portillo Loria, Gloriana Madrigal Sanchez Valenzuela, Maria C Fernandez Felix, Daniel A Castano, Yennifer Gil Sharma, Sapna Arias Morales, Carlos E J Endocr Soc Thyroid Hashimoto encephalopathy (HE) is a term used to describe an encephalopathy of presumed autoimmune origin characterized by high titers of antithyroid peroxidase antibodies, an essential feature of this disorder. Pertinent laboratory findings include an elevated serum level of antithyroid peroxidase antibody (TPOAb) and/or antithyroglobulin antibody (TgAb) and negative autoimmune markers of encephalitis in cerebrospinal fluid (CSF). The analysis of CSF may show increased cellularity due to lymphocytic pleocytosis. However, there is no clear relationship between the severity of neurologic symptoms and the type or serum concentration of antibodies. Approximately two-thirds of patients of HE will experience seizures. Patients can present with a recurrence/remission or a diffuse, progressive pattern characterized by slowly progressive cognitive impairment with dementia, confusion, or hallucinations. We present a rare case of Hashimoto's encephalopathy associated with hyperthyroidism in a 61-year-old man evaluated for left facial droop and right upper extremity weakness, successfully treated with corticosteroids and methimazole. We conclude that the diagnosis of HE should be suspected early and be on the differential in patients who present with encephalopathy, which workup shows positive anti-thyroid antibodies and CSF with lymphocytosis. Treatment for meningitis or other life-threatening conditions should never be postponed, as HE is a diagnosis of exclusion that usually requires an extensive laboratory and diagnostic workup. Early diagnosis has an excellent outcome once treatment is started as it is a steroid-responsive encephalopathy associated with autoimmune thyroiditis. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m. Oxford University Press 2022-11-01 /pmc/articles/PMC9625549/ http://dx.doi.org/10.1210/jendso/bvac150.1545 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Thyroid Canales, Shellsea Portillo Loria, Gloriana Madrigal Sanchez Valenzuela, Maria C Fernandez Felix, Daniel A Castano, Yennifer Gil Sharma, Sapna Arias Morales, Carlos E LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male |
title | LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male |
title_full | LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male |
title_fullStr | LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male |
title_full_unstemmed | LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male |
title_short | LBSAT313 Hashimoto Encephalitis Presenting With Stroke-like Symptoms In An Adult Male |
title_sort | lbsat313 hashimoto encephalitis presenting with stroke-like symptoms in an adult male |
topic | Thyroid |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625549/ http://dx.doi.org/10.1210/jendso/bvac150.1545 |
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