Hashimoto’s encephalopathy associated with an elevated intrathecal IgG4 level

Hosoi, Yasushi; Kono, Satoshi; Terada, Tatsuhiro; Konishi, Takashi; Miyajima, Hiroaki

doi:10.1007/s00415-013-6878-2

Cited by 11 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pathophysiologic uniformity of SREAT has been questioned repeatedly, and publications in recent years have shown that many previously non‐categorized encephalopathy syndromes can be assigned to specific autoimmune mechanisms . This makes the study of those patients that remain being categorized as SREAT/HE, all the more promising .…”

Section: Introductionmentioning

confidence: 99%

Initial serum thyroid peroxidase antibodies and long-term outcomes in SREAT

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Initial serum thyroid peroxidase antibodies and long-term outcomes in SREAT

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Currently, the IgG4-RD group includes a considerable number of autoimmune diseases, e.g., sclerosing cholangitis, interstitial nephritis, Sjögren’s syndrome, Riedel’s goiter or chronic thyroiditis [ 70 , 71 , 72 ]. Hosoi et al [ 73 ] described a 60-year-old man with features of severe Hashimoto encephalopathy who had elevated IgG4 levels in both serum and cerebrospinal fluid. The patient’s IgG4 index was lower than that of IgG, indicating passive transport of IgG4 across the blood–brain barrier rather than primary synthesis of this immunoglobulin fraction in the CNS.…”

Section: Resultsmentioning

confidence: 99%

Hashimoto Encephalopathy—Still More Questions than Answers

Waliszewska‐Prosół

Ejma

2022

Cells

View full text Add to dashboard Cite

The normal function of the nervous system is conditioned by the undisturbed function of the thyroid gland and its hormones. Comprehensive clinical manifestations, including neurological disorders in Hashimoto’s thyroiditis, have long been understood and, in recent years, attention has been paid to neurological symptoms in euthyroid patients. Hashimoto encephalopathy is a controversial and poorly understood disease entity and the pathogenesis of the condition remains unclear. We still derive our understanding of this condition from case reports, but on the basis of these, a clear clinical picture of this entity can be proposed. Based on a review of the recent literature, the authors present the current view on the subject, discuss controversies and questions that still remain unanswered, as well as ongoing research in this area and the results of our own work in patients with Hashimoto’s thyroiditis.

show abstract

“…Steroid-responsive encephalopathy associated with autoimmune thyroiditis remains a poorly understood disease, although various indicators for its inflammatory origin exist, including presence of perivascular lymphocytic infiltrates, depositions of immunoglobulin G subtype 4 within the central nervous system (CNS), an association with various autoimmune diseases besides thyroiditis, and -of course -its strong response towards corticosteroid treatment [9][10][11]. The role of antithyroid antibodies, however, remains unclear as they correlate poorly with disease activity and are regularly found in healthy individuals [6,12].…”

Section: Discussionmentioning

confidence: 99%

Patients with a relapsing course of steroid‐responsive encephalopathy associated with autoimmune thyroiditis exhibit persistent intrathecal CD4+ T‐cell activation

Pfeuffer

Ruck

Rolfes

et al. 2020

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose Steroid‐responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a rare condition defined by encephalopathy with acute or subacute onset, the presence of serum anti‐thyroid antibodies, and reasonable exclusion of alternative causes. Despite having strong response towards corticosteroid treatment, some patients exhibit a chronic‐relapsing course and require long‐term immunosuppression. Markers for early identification of those patients are still absent. Thus, we aimed to characterise clinical as well as laboratory parameters of our local SREAT cohort. Methods We retrospectively evaluated a cohort of 22 SREAT patients treated in our hospital from January 2014. Results A total of 14 patients with a monophasic disease course and eight patients with multiple relapses were identified. Neither baseline characteristics nor routine cerebrospinal fluid (CSF) parameters were able to distinguish between those patient groups. Flow cytometry following initial relapse therapy showed treatment‐resistant sequestration of activated CD4+ T cells in patients with a relapsing disease course, whereas other lymphocyte subsets showed uniform changes. Such changes were also present in long‐term follow‐up CSF examination. Conclusion Our findings indicate a potential biomarker for risk stratification in patients with SREAT. Currently, it remains unclear whether the observed two phenotypes are different spectra of SREAT or represent separate diseases in terms of pathophysiology.

show abstract

Hashimoto’s encephalopathy associated with an elevated intrathecal IgG4 level

Cited by 11 publications

References 15 publications

Initial serum thyroid peroxidase antibodies and long-term outcomes in SREAT

Initial serum thyroid peroxidase antibodies and long-term outcomes in SREAT

Hashimoto Encephalopathy—Still More Questions than Answers

Patients with a relapsing course of steroid‐responsive encephalopathy associated with autoimmune thyroiditis exhibit persistent intrathecal CD4+ T‐cell activation

Contact Info

Product

Resources

About