Antithyroid antibodies in the CSF

Ferracci, Franco; Moretto, Giuseppe; Candeago, R. M.; Cimini, Nicola; Conte, Francesca; Gentile, Mauro; Papa, Nicoletta Del; Carnevale, Antonio

doi:10.1212/01.wnl.0000048660.71390.c6

Cited by 161 publications

(78 citation statements)

References 5 publications

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“…These results suggest that the immune-mediated brain damage is more limited in ataxic HE than in other clinical forms, and that CSF and EEG findings cannot distinguish the cerebellar ataxic form of HE from SCD. Ferracci et al [22] reported finding antithyroid Abs in the CSF of patients with HE and that this finding was useful for diagnosing HE. As in SCD patients, however, anti-TPO Abs were not detected in the CSF of the patients in the present study.…”

Section: Discussionmentioning

confidence: 99%

Hashimoto’s Encephalopathy as a Treatable Adult-Onset Cerebellar Ataxia Mimicking Spinocerebellar Degeneration

et al. 2012

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Background: Hashimoto’s encephalopathy (HE) presents with a variety of neurologic and neuropsychiatric features. In this study, we investigated the clinical and immunological profiles of the cerebellar ataxic form of HE. Methods: The clinical features, treatments, laboratory features, brain imaging, and serum anti-NH₂-terminal of α-enolase autoantibodies (anti-NAE Abs), a useful diagnostic marker for HE, were investigated in 13 patients who presented with sporadic adult-onset cerebellar ataxia and fulfilled the HE diagnostic criteria (antithyroid Abs and responsiveness to immunotherapy). Results: All of the patients presented with truncal ataxia, but nystagmus was uncommon (17%). Eight patients had an insidious onset that mimicked spinocerebellar degeneration (SCD), but brain imaging showed little or no cerebellar atrophy in all of the patients. Those patients with serum anti-NAE Abs (n = 8) did not have nystagmus and tended to respond better to immunotherapy than the anti-NAE Ab-negative patients. Conclusion: The present study suggests that insidious adult-onset and truncal ataxia are common in the cerebellar ataxic form of HE, which mimics SCD, but that nystagmus and severe cerebellar atrophy are uncommon. Antithyroid and anti-NAE Abs may be useful for diagnosing cerebellar ataxic HE.

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Section: Discussionmentioning

confidence: 99%

Hashimoto’s Encephalopathy as a Treatable Adult-Onset Cerebellar Ataxia Mimicking Spinocerebellar Degeneration

et al. 2012

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“…Cerebrospinal fluid (CSF) analysis is abnormal in approximately 80 percent of patients, usually revealing an elevated CSF protein level (9). Unfortunately, the present patient refused the examination, so we could not analyze the patient's CSF.…”

Section: Discussionmentioning

confidence: 83%

Recurrent Hashimoto's Encephalopathy, Showing Spontaneous Remission: A Case Report

et al. 2011

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Hashimoto's encephalopathy (HE) is a rare condition associated with Hashimoto's thyroiditis (HT). It is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, non-specific radiological examinations or electroencephalogram abnormalities, and responsiveness to corticosteroid treatment. We describe the case of a man with HE who showed decreased mentality, cognitive impairment, dysarthria, and gait disturbance. The initial attack was improved rapidly by corticosteroid treatment. When the symptoms recurred in 7 months, the patient achieved spontaneous remission without corticosteroid treatment. The recognition of the condition was essential for the prognosis and treatment of this rare disease.

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“…Recent studies have shown the presence of anti-thyroid antibodies in the CSF 5 and alpha-enolase antibodies in the serum of patients with Hashimoto' s encephalopathy, suggesting the involvement of an autoimmune mechanism in this condition 6 . However, the role of those antibodies and their pathophysiology are unknown.…”

Section: Discussionmentioning

confidence: 99%

Hashimoto's encephalopathy with clinical features similar to those of Creutzfeldt-Jakob disease

Cerqueira

Bezerra

Magalhães

et al. 2008

Arq. Neuro-Psiquiatr.

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In 1966, Brain et al. described the first case of Hashimoto's encephalopathy in a patient with stroke-like episodes, seizure activities, and delirium. The symptoms were recurrent and reversible and were not associated with thyroid dysfunction 1 . Since then, Hashimoto's encephalopathy has been recognized as a rare condition associated to Hashimoto's thyroiditis and to the presence of high concentrations of antithyroid antibodies, unlike those described in myxedema and in thyrotoxicosis 2 . Two clinical forms have been described: the vasculitic form with stroke-like episodes, seizure activities, and slight cognitive decline; and the diffuse form with symptoms of depression, psychosis, myoclonus, tremors, delusion, fluctuations in the level of consciousness, and dementia. The clinical manifestations can be fluctuating or persistent, and reversible, if properly treated with immunosuppressive therapy 3 . In some cases, Hashimoto's encephalopathy can show rapidly progressive dementia, myoclonus, and electroencephalographic changes with periodic recurrence of the triphasic complexes similar to those of Creutzfeldt-Jakob disease, which makes a differential diagnosis essential to both pathologies 4 . We describe the case of a patient with Hashimoto's encephalopathy who showed clinical manifestations similar to those of Creutzfeldt-Jakob disease. The recognition of the condition was essential for the treatment and regression of the clinical presentation. CaSEA female patient, 68-years-old, Caucasian, widow, born in Rio de Janeiro, developed a clinical presentation of daily sadness, discouragement, decreased appetite, insomnia, and cognitive decline. The condition of the patient worsened with persecutory delusions, visual hallucinations, gait disturbance, tremor of the extremities, muscle spasms, and fluctuations in the level of consciousness. She had a history of hypothyroidism and did not use any medication. At admission, she was sleepy, disoriented, showing myoclonus, paratonia on the back of the head and arms, her deep reflexes were symmetrical with plantar flexion response and suction and grasping reflexes were present. The rest of the physical examination was normal.The laboratory exams, including a complete blood count; biochemistry; arterial gasometry; hepatic function tests; autoantibody tests, such as anti-nuclear factor (ANF), anti-Ro, antiLa, pANCA and cANCA, were either normal or negative. The lev-

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Antithyroid antibodies in the CSF

Cited by 161 publications

References 5 publications

Hashimoto’s Encephalopathy as a Treatable Adult-Onset Cerebellar Ataxia Mimicking Spinocerebellar Degeneration

Hashimoto’s Encephalopathy as a Treatable Adult-Onset Cerebellar Ataxia Mimicking Spinocerebellar Degeneration

Recurrent Hashimoto's Encephalopathy, Showing Spontaneous Remission: A Case Report

Hashimoto's encephalopathy with clinical features similar to those of Creutzfeldt-Jakob disease

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