Hashimoto's encephalopathy. Report of four cases
Hashimoto's encephalopathy. Report of four cases
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DOI：
10.1016/s0248-8663(01)00403-9
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发表时间：
2001-07-01
影响因子：
0.9
通讯作者：
Teissier, MP
中科院分区：
文献类型：
--
作者：
Archambeaud, F;Galinat, S;Teissier, MP
导论. - 桥本氏甲状腺炎相关的脑病已被认识30多年，但可能被低估了。- 我们报告四例桥本甲状腺炎的神经或精神方面的特点。有3名女性和1名男性，平均年龄为68岁。神经系统表现多种多样：癫痫发作、精神病发作、意识改变、幻觉，无常见病因疾病（感染性、代谢性、肿瘤性、血管性等）。神经系统检查（EEG、脑CT、磁共振成像）无特异性。在所有的病例中，都发现了中等程度的高CSF蛋白水平，没有白细胞增多。患者表现为轻微的甲状腺功能减退，抗甲状腺过氧化物酶抗体滴度高。尽管激素治疗替代，神经功能的特点仍然存在。激素治疗的结果是有利的。- 桥本脑病必须考虑在面对神经精神表现没有明显的病因。发病机制尚不清楚，但可能涉及自身免疫性脑血管炎，因为类固醇的疗效。(C)2001年，Elsevier SAS科学与医学版。
Introduction. - Encephalopathy associated with Hashimoto's thyroiditis has been recognized for more than 30 years and is probably underestimated.Exegesis. - We report four patients with Hashimoto's thyroiditis who presented neurological or psychiatric features. There were three women and one man, with a mean age of 68 years. Neurological presentations were various: seizures, psychotic episodes, altered consciousness, hallucinations without usual aetiological diseases (infectious, metabolic, neoplasic, vascular, etc.). Neurological investigations (EEG, brain CT, magnetic resonance imaging) were unspecific. In all cases, a moderately high CSF protein level without pleocytosis was found. Patients presented slight hypothyroidism with high titers of antithyroperoxidase antibodies. Despite hormone therapy replacement, neurological features persisted. Outcome was favorable under steroid therapy.Conclusion. -Hashimoto's encephalopathy must be considered in the face of neuropsychiatric manifestations without obvious etiology. Pathogenic mechanisms are not clear but probably involve autoimmune cerebral vasculitis because of the efficacy of steroids. (C) 2001 Editions scientifiques et medicales Elsevier SAS.