Steroid-Responsive Recurrent Encephalopathy Associated with Subacute Thyroiditis
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background Steroid-responsive encephalopathy associated with subacute thyroiditis has, to our knowledge, not been reported previously. Case Report A 49-year-old woman was found collapsed and brought to our institution with decreased mentality, dysarthria, and gait disturbance. Brain magnetic resonance imaging and angiography were normal but blood tests revealed thyroid-autoantibody-negative thyrotoxicosis. Results of a 99mtechnetium-pertechnetate scan were compatible with the thyrotoxic phase of subacute thyroiditis. 14-3-3 proteins were detected in cerebrospinal fluid. Her mental status began to improve from the day following steroid administration. Recurrent encephalopathy was found 2 months after the initial admission, which was also effectively treated with steroid. Conclusions We speculate that steroid-responsive recurrent encephalopathy associated with subacute thyroiditis is a subtype of Hashimoto’s encephalopathy, and consider that steroid treatment should not be delayed in suspected patients.
Abstract
Background Steroid-responsive encephalopathy associated with subacute thyroiditis has, to our knowledge, not been reported previously. Case Report A 49-year-old woman was found collapsed and brought to our institution with decreased mentality, dysarthria, and gait disturbance. Brain magnetic resonance imaging and angiography were normal but blood tests revealed thyroid-autoantibody-negative thyrotoxicosis. Results of a 99mtechnetium-pertechnetate scan were compatible with the thyrotoxic phase of subacute thyroiditis. 14-3-3 proteins were detected in cerebrospinal fluid. Her mental status began to improve from the day following steroid administration. Recurrent encephalopathy was found 2 months after the initial admission, which was also effectively treated with steroid. Conclusions We speculate that steroid-responsive recurrent encephalopathy associated with subacute thyroiditis is a subtype of Hashimoto’s encephalopathy, and consider that steroid treatment should not be delayed in suspected patients.
참고문헌 (17)
- Brain L, "Hashimoto’s disease and encephalopathy", Lancet, 2, pp.512~514 (1966)
- Castillo P, "Steroid-responsive encephalopathy associated with autoimmune thyroiditis", Arch Neurol, 63, pp.197~202 (2006)
- 강사윤, "Two Cases of Hypertensive Encephalopathy Involving the Brainstem", Journal of Clinical Neurology, 3(1), pp.50~52 (2007), 대한신경과학회
- McHugh JC, "Steroid-responsive recurrent encephalopathy in a patient with cerebral amyloid angiopathy", Cerebrovasc Dis, 23, pp.66~69 (2007)
- Chong JY, "Hashimoto encephalopathy: syndrome or myth", Arch Neurol, 60, pp.164~171 (2003)
- Vernino S, "Autoimmune encephalopathies", Neurologist, 13, pp.140~147 (2007)
- Creutzfeldt CJ, "Hashimoto encephalopathy: a do-not-miss in the differential diagnosis of dementia", J Neurol, 252, pp.1285~1287 (2005)
- Doherty CP, "Hashimoto’s encephalopathy mimicking Creutzfeldt-Jakob disease: brain biopsy findings", J Neurol Neurosurg Psychiatry, 733, pp.601~602 (2002)
- Yuceyar N, "Thyrotoxic autoimmune encephalopathy in a female patient: only partial response to typical immunosuppressant treatment and remission after thyroidectomy", Clin Neurol Neurosurg, 109, pp.458~462 (2007)
- Yoneda M, "High prevalence of serum autoantibodies against the amino terminal of alpha-enolase in Hashimoto’s encephalopathy", J Neuroimmunol, 185, pp.195~200 (2007)
- Oide T, "Anti-neuronal autoantibody in Hashimoto’s encephalopathy: neuropathological, immunohistochemical, and biochemical analysis of two patients", J Neurol Sci, 217, pp.7~12 (2004)
- Seo SW, "Thyrotoxic autoimmune encephalopathy: a repeat positron emission tomography study", J Neurol Neurosurg Psychiatry, 74, pp.504~506 (2003)
- Katoh N, "An 85-year-old case with Hashimoto’s encephalopathy, showing spontaneous complete remission", Intern Med, 46, pp.1613~1616 (2007)
- Chong JY, "What’s in a NAIM? Hashimoto encephalopathy, steroid-responsive encephalopathy associated with autoimmune thyroiditis, or nonvasculitic autoimmune meningoencephalitis", Arch Neurol, 63, pp.175~176 (2006)
- Utsumiya K, "A case of steroid-responsive encephalopathy with positive 14-3-3 protein of the cerebrospinal fluid clinically resembling Creutzfelt-Jakob disease", Rinsho Shinkeigaku, 44, pp.618~622 (2004)
- Fu H, "proteins: structure, function, and regulation", Annu Rev Pharmacol Toxicol, 40, pp.617~647 (2000)
- Fujii K, "14-3-3 protein detection in the cerebrospinal fluid of patients with influenza-associated encephalopathy", J Child Neurol, 21, pp.562~565 (2006)
