Clinical characteristics of paediatric Hashimoto's encephalopathy

Boelen, Roos; Vries, Tjalling de

doi:10.1016/j.ejpn.2021.04.006

Cited by 8 publications

(7 citation statements)

References 52 publications

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“…Both hypothyroidism and hyperthyroidism can affect brain function [12]. However, the present study showed that the majority of patients in both groups were euthyroid, in line with the literature [3,11,13,14]. The increased thyroid antibodies are currently a diagnostic criterion for SREAT, whereby HT is not necessarily -not even often -associated with SREAT [8].…”

Section: Discussionsupporting

confidence: 88%

“…Many authors have considered the antibodies to be innocent bystanders, whereas other researchers believe that the increase of autoantibody levels is proportional to the activity of the disease and that their level decreases after treatment with corticosteroids [3]. In line with the literature, anti-TPO was the most common antibody not only in SREAT but also in sCJD [13,15,16], while anti-TG is observed more commonly in SREAT patients. In clinical terms, it is noteworthy that the sole occurrence of anti-TPO for sCJD and the combination of anti-TPO and anti-TG rather speaks for SREAT.…”

Section: Discussionmentioning

confidence: 87%

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Steroid-responsive encephalopathy in autoimmune thyroiditis (SREAT) as a differential diagnosis of Creutzfeldt-Jakob disease

Osmanlıoğlu

Zerr

2023

Neurol Neurochir Pol.

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Introduction. Steroid-responsive encephalopathy in autoimmune thyroiditis (SREAT) is characterised by a wide range of neuropsychiatric symptoms and elevated thyroid antibodies. SREAT can mimic sporadic Creutzfeldt-Jakob disease (sCJD) and distinguishing between both entities is important because SREAT responds to corticosteroids.Material and methods. Data of patients reported to the National Reference Centre for the Surveillance of CJD in Göttingen, Germany between August 1994 and October 2008 was retrospectively reviewed. In the case and control groups, 49 patients had SREAT and 48 had sCJD with elevated thyroid antibodies.Results. Antibodies against thyroid peroxidase were the most common antibodies in both SREAT (86%) and sCJD (88%), followed by antibodies against thyroglobulin (SREAT, 63.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 87%

Steroid-responsive encephalopathy in autoimmune thyroiditis (SREAT) as a differential diagnosis of Creutzfeldt-Jakob disease

Osmanlıoğlu

Zerr

2023

Neurol Neurochir Pol.

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“…A broad clinical spectrum of HE has been described including behavioral changes cognitive decline, confusion, stroke‐like episodes and seizures 24,26 . A substantial proportion develop late sequelae, mostly epilepsy 32 . Notably, the existence of the nosological entity of HE remains widely debated with some doubt of the existence of this type of encephalopathy and its features that have long been considered characteristic of it, including response to steroids.…”

Section: Resultsmentioning

confidence: 99%

“… 24 , 26 A substantial proportion develop late sequelae, mostly epilepsy. 32 Notably, the existence of the nosological entity of HE remains widely debated with some doubt of the existence of this type of encephalopathy and its features that have long been considered characteristic of it, including response to steroids. The reader is referred to Mattozzi et al 27 for further reading.…”

Section: Resultsmentioning

confidence: 99%

Thyroid Disorders and Movement Disorders—A Systematic Review

Schneider

Tschaidse

Reisch

2023

Movement Disord Clin Pract

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Background There is overlap between movement disorders and neuroendocrine abnormalities. Objectives and methods To provide a systematic review on the association of thyroid dysfunction and movement disorders. Thyroid physiological function and classical thyroid disorders highlighting typical and atypical manifestations including movement disorders, as well as diagnostic procedures, and treatments are discussed. Results Hypothyroidism may be associated with hypokinetic and hyperkinetic disorders. There is debate whether their concomitance reflects a causal link, is coincidence, or the result of one unmasking the other. Hypothyroidism‐associated parkinsonism may resemble idiopathic Parkinson's disease. Hypothyroidism‐associated hyperkinetic disorders mainly occur in the context of steroid‐responsive encephalopathy with autoimmune thyroiditis, that is, Hashimoto disease, mostly manifesting with tremor, myoclonus, and ataxia present in 28–80%, 42–65% and 33–65% in larger series. Congenital hypothyroidism manifesting with movement disorders, mostly chorea and dystonia, due to Mendelian genetic disease are rare. Hyperthyroidism on the other hand mostly manifests with hyperkinetic movement disorders, typically tremor (present in three quarters of patients). Chorea (present in about 2% of hyperthyroid patients), dystonia, myoclonus, ataxia and paroxysmal movement disorders, as well as parkinsonism have also been reported, with correlation between movement intensity and thyroid hormone levels. On a group level, studies on the role of thyroid dysfunction as a risk factor for the development of PD remain non‐conclusive. Conclusions In view of the treatability of movement disorders associated with thyroid disease, accurate diagnosis is important. The pathophysiology remains poorly understood. More detailed case documentation and systematic studies, along with experimental studies are needed.

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“…Entre los síntomas neurológicos se incluye episodios similares a ictus, convulsiones, demencia, mioclonías, mielopatías compatibles con encefalopatías no específicas [3] y, entre los síntomas psiquiátricos, el más frecuente son las alteraciones sensoperceptivas. También pueden estar presentes alteraciones del comportamiento y del pensamiento [4]. Es criterio fundamental encontrar al menos a un anticuerpo antitiroideo francamente elevado.…”

Section: Introductionunclassified

Debut with psychotic symptoms of Hashimoto encephalopathy: A case report

Arce¹,

Sánchez-Rueda²

2022

Medwave

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Hashimoto’s encephalopathy is a rare disease, first reported in 1966, with a prevalence of 2.1 in 1000 inhabitants. We present the case of a 42- year- old woman, with no relevant medical history, who suddenly started having symptoms of altered consciousness, visual hallucinations and de-lusions. Laboratory tests showed anti- thyroperoxidase antibodies greater than 600 U/ml, thy-roxin 0.93 U/ml, and thyroid stimulating hormone 1.60 U/ml. Magnetic resonance imaging showed bilateral subcortical focal lesions with a nonspecific demyelinating appearance. The electroencephalogram was nonspecific. The diagnosis of Hashimoto encephalopathy was made, and symptoms remitted after treatment with steroids. This article highlights the importance of conducting a comprehensive evaluation of patients with atypical psychiatric symptoms and a thorough differential diagnosis.

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Clinical characteristics of paediatric Hashimoto's encephalopathy

Cited by 8 publications

References 52 publications

Steroid-responsive encephalopathy in autoimmune thyroiditis (SREAT) as a differential diagnosis of Creutzfeldt-Jakob disease

Steroid-responsive encephalopathy in autoimmune thyroiditis (SREAT) as a differential diagnosis of Creutzfeldt-Jakob disease

Thyroid Disorders and Movement Disorders—A Systematic Review

Debut with psychotic symptoms of Hashimoto encephalopathy: A case report

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