Pediatric <scp>H</scp>ashimoto's encephalopathy with peripheral nervous system involvement

Salpietro, Vincenzo; Mankad, Kshitij; Polizzi, Agata; Sugawara, Yuji; Granata, Francesca; David, Emanuele; Ferraù, Valeria; Gallizzi, Romina; Tortorella, Gaetano; Ruggieri, Martino

doi:10.1111/ped.12262

Cited by 12 publications

(3 citation statements)

References 12 publications

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“…13 To the best our knowledge, peripheral nerve involvement in HE was reported in only one case in the pediatric literature. Salpietro et al 16 reported a 13-year-old girl with HE who developed distal neuropathy. Her electromyography and nerve conduction velocity tests showed prolonged sensory latencies and reduced amplitude of action potentials in the upper and lower limbs segments with absent F-waves in the popliteal regions and the ankles bilaterally; motor conduction velocity was normal, indicating distal neuropathy (likely a polyneuropathy).…”

Section: Discussionmentioning

confidence: 99%

A case of steroid-resistance Hashimoto's encephalopathy presenting with sensorimotor polyneuropathy

et al. 2018

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Hashimoto's encephalopathy (HE) is a rare, auto-immune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. The course of most HE cases is relapsing and remitting, which is similar to that of vasculitis and stroke. Steroids are the first line treatment in HE. In steroid non-responders other immunomodulatory therapies or plasmapheresis could be applied. We report a case of steroidresistance HE with sensorimotor polyneuropathy, as a rare presentation of this disorder. Our case showed that HE may present with sensorimotor polyneuropathy; therefore HE should be considered in the differential diagnoses of polyneuropathy.

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Section: Discussionmentioning

confidence: 99%

A case of steroid-resistance Hashimoto's encephalopathy presenting with sensorimotor polyneuropathy

et al. 2018

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“…Epidemiológicamente se estima una prevalencia de 2.1/100,000 casos 4 con una relación hombre/ mujer de 1:4, aunque puede afectar a jóvenes y niños 5,6 . Se asocia a otras patologías de condición autoinmune como la tiroiditis de Hashimoto, la hashitoxicosis, el síndrome de Sjögren, el lupus eritematoso sistémico, la enfermedad de Basedow 7 , la diabetes mellitus tipo 1, la sarcoidosis y la enfermedad de Biermer 8,9 .…”

Section: Discussionunclassified

Encefalopatía asociada a distiroidismo con anticuerpos antiperoxidasa positivos

et al. 2016

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Introducción: La encefalopatía de Hashimoto (EH) es una patología asociada a distiroidismo y a otras enfermedades de carácter autoinmune. La fisiopatología no es precisa y clínicamente la enfermedad se caracteriza por alteraciones neurológicas y psiquiatricas en ausencia de infección cerebral. Los anticuerpos antitiroideos son elevados y los estudios de imagen pueden ser normales. La corticoterapia es el tratamiento de elección. Reporte de caso: femenino de 36 años de edad con monoparesia, alteraciones de la conducta y la personalidad, además de hipertiroidismo. Se realiza punción lumbar y se descartan causas infecciosas, metabólicas y neoplásicas de encefalopatía, por lo cual se solicita resonancia magnética de cráneo, con reporte de imágenes compatibles con abscesos cerebrales diversos de origen por determinar. Al considerarse una probable encefalopatía de Hashimoto, se solicitan anticuerpos anti tiroglobulina y antiperoxidasa, detectándose títulos elevados. Se inició corticoterapia y posteriormente esquema de inmunoglobulina con pobre respuesta al tratamiento. Conclusiones: este caso asocia una encefalopatía de Hashimoto en una paciente con hipertiroidismo, asociación poco frecuente reportada en la literatura. Se sospechó de una vasculitis primaria de SNC debido a los valores elevados de complemento; sin embargo, no se realizó biopsia cerebral para definir un diagnóstico más preciso.

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“…10,17 This type of presentation is typical of childhood PTCS, and therefore it is important to exclude in patients with a possible underlying infectious and/or parainfectious process of the brain or spine and a postinflammatory torticollis. 29,30 Pulsatile tinnitus, also known as pulsesynchronous tinnitus, is another symptom of pediatric PTCS. 7,10 Pulsatile tinnitus is common in PTCS with and without papilledema and does not differ in its incidence between these two forms of PTCS.…”

Section: Clinical Assessment Of Pediatric Ptcsmentioning

confidence: 99%

Clinical Assessment and Differential Diagnosis of Pediatric Pseudotumor Cerebri Syndrome: Pearls and Pitfalls

2015

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Pseudotumor cerebri syndrome (PTCS) is defined by the presence of elevated intracranial pressure in the setting of normal brain parenchyma and normal cytologic and chemical analyses of the cerebrospinal fluid. Pathophysiology of this syndrome remains unclear, while its incidence may be potentially rising in children. The presenting signs and symptoms of PTCS are heterogeneous to usually include headache, papilledema, and visual disturbances (i.e., vision loss or double vision). The clinical features of PTCS in children have changed over the years, making the diagnosis challenging in some cases. Young children may present with atypical symptoms, such as those mimicking a posterior fossa tumor. There are reports of PTCS in children in the absence of headache. Papilledema, considered the acute hallmark of PTCS at onset, can also be absent. It is thus important for pediatricians to recognize atypical presentations especially as previous studies have suggested children presenting with headache in the absence of papilledema or those with papilledema in the absence of any other clinical signs may have increased risk of developing visual constriction deficits and permanent loss of vision, respectively. Moreover, many conditions in the pediatric age group may mimic PTCS, such as migraine and tension headaches. Cerebral venous sinus thrombosis and some neoplastic processes such as gliomatosis cerebri and leptomeningeal spread of hematologic malignancies are known to augment intracranial pressure and have to be carefully excluded. To avoid misdiagnosis and potential long-term sequel, a thorough clinical assessment is crucial to promptly and correctly recognize PTCS.

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Pediatric Hashimoto's encephalopathy with peripheral nervous system involvement

Cited by 12 publications

References 12 publications

A case of steroid-resistance Hashimoto's encephalopathy presenting with sensorimotor polyneuropathy

A case of steroid-resistance Hashimoto's encephalopathy presenting with sensorimotor polyneuropathy

Encefalopatía asociada a distiroidismo con anticuerpos antiperoxidasa positivos

Clinical Assessment and Differential Diagnosis of Pediatric Pseudotumor Cerebri Syndrome: Pearls and Pitfalls

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