Encefalopatía de Hashimoto: reporte de un caso clínico

Priscila Specht; Romina Rey; Florencia Sacchi; Andrea Vaucher-Rivero; Mario Llorens

doi:10.32818/reccmi.a4n1a12

Authors

Priscila Specht Clínica Médica 3, Hospital Maciel. Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Romina Rey Clínica Médica 3, Hospital Maciel. Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Florencia Sacchi Clínica Médica 3, Hospital Maciel. Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Andrea Vaucher-Rivero Clínica Médica 3, Hospital Maciel. Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
Mario Llorens Clínica Médica 3, Hospital Maciel. Facultad de Medicina, Universidad de la República, Montevideo, Uruguay

DOI:

https://doi.org/10.32818/reccmi.a4n1a12

Keywords:

Hashimoto encephalopathy, autoimmune, corticoids.

Abstract

Hashimoto encephalopathy is an infrequent neurological entity, rarely suspected by the clinician. It is of a probable autoimmune nature, it generally presents with subacute symptoms; in thrusts and remissions, high titers of antithyroid antibodies and good response to corticosteroid treatment. We present the clinical case of a 78-year-old man with multiple pathological antecedents who consulted in Hospital Maciel, Montevideo, Uruguay for symptoms of 3 weeks of evolution characterized by psychomotor excitement, language and behavioral alterations. Other causes of encephalopathy were excluded. Clinical tests revealed euthyroidism with elevated antithyroid antibodies and the improvement of symptoms after starting corticotherapy was evidenced.

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References

Tang Y, Xing Y, Lin M, Zhang J, Jia J. Hashimoto's encephalopathy cases: chinese experience. BMC Neurology. 2012 Jul 24; 12(1): 60-66. doi: https://doi.org/10.1186/1471-2377-12-60.

Laurent C, Capron J, Quillerou B, Thomas G, Alamowitch S, Fain O, Meki- nian A. Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT): characteristics, treatment and outcome in 251 cases from the literature. Autoimmun Rev. 2016 Dec; 15(12): 1129-1133. doi: https://doi.org/10.1016/j.autrev.2016.09.008.

Castillo P, Woodruff B, Caselli P, Vernio S, Lucchinetti C, Swanson J, et al. Steroid-responsive encephalopathy associated with autoimmune thyroiditis. Arch Neurol. 2006 Feb; 63(2): 197-202. doi: https://doi.org/10.1001/archneur.63.2.197.

Olmez I, Moses H, Sriram S, Kirshner H, Lagrange AH, Pawate S. Diagnostic and therapeutic aspects of Hashimoto's encephalopathy. J Neurol Sci. 2013 Aug 15; 331(1-2): 67-71. doi: https://doi.org/10.1016/j.jns.2013.05.009.

Kirshner HS. Hashimoto's encephalopathy: a brief review. Curr Neurol Neurosci Rep. 2014 Sep; 14(9): 476. doi: https://doi.org/10.1007/s11910-014-0476-2.

Posadas-Zúñiga G, Palafox-Vigil G, Garcéa-Esquivel MA. Encefalopatía de Hashimoto: reporte de un caso. Rev Mex Neuroci. 2013; 14(2): 86- 88.

Zamora-Elson M, Labarta-Monzón L, Mallor-Bonet T, Villacampa-Clavér V, Avellanas-Chavala M, Serón-Arbeloa C. Encefalitis de Hashimoto, a propósito de un caso. Med Intensiva. 2014; 38(8): 522-523. doi: https://doi.org/10.1016/j.medin.2013.03.011.

Mantilla S, Guerrero A, Montoya L, Giraldo K, Aguirre H. Encefalopatía de Hashimoto: reporte de caso y revisión de la literatura. Neurol Arg. 2018. doi: https://doi.org/10.1016/j.neuarg.2018.08.001.

Jacob S, Rajabally YA. Hashimoto's encephalopathy: steroid resistance and response to intravenous inmmunoglobulins. J Neurol Neurosurg Psychiatry. 2005; 76: 455. doi: https://doi.org/10.1136/jnnp.2004.049395.

Drulović J, Andrejević S, Bonaci-Nikolić B, Mijailović V. Hashimoto's encephalopathy: a long-lasting remission induced by intravenous immunoglobulins. Vojnosaint Pregl. 2011 May; 68(5): 452-454.

Nieuwenhuis L, Santens P, Vanwalleghem P, Boon P. Subacute Hashimoto's encephalopathy, treated with plasmapheresis. Acta Neurol Belg. 2004 Jun; 104(2): 80-83.

Nagpal T, Pande S. Hashimoto's encephalopathy. Response to plasma exchange. Neurol India. 2004; 52(2): 245-247.

Boers PM, Colebatch JG. Hashimoto's encephalopathy responding to plasmapheresis. J Neurol Neurosurg Psychiatry. 2001 Jan; 70(1): 132.

Yu HJ, Lee J, Seo DW, Lee M. Clinical manifestations and treatment response of steroid in pediatric Hashimoto encephalopathy. J Child Neurol. 2014 Jul; 29(7): 938-942. doi: https://doi.org/10.1177/0883073813499823.

Maas A, Braun KP, Geleijns K, Jansen FE, van Royen-Kerkhof A. Risks and benefits of rituximab in the treatment of Hashimoto’s encephalopathy in children: two case reports and a mini review. Pediatric Neurology. 2017 Jan; 66: 28-31. doi: https://doi.org/10.1016/j.pediatrneurol.2016.09.002.

Mamoudjy N, Korff C, Maurey H, Blanchard G, Steshenko D, Loiseau-Corvez MN, Husson B, Brauner R, Tardieu M, Deiva K. Hashimoto's encephalopathy: identification and long-term outcome in children. Eur J Paediatr Neurol. 2013 May; 17(3): 280-287. doi: https://doi.org/10.1016/j.ejpn.2012.11.003.