Autoimmune encephalopathy associated with thyroid autoantibodies as the cause of reversible cognitive impairment

We herewith describe a patient with acute confusion, expressive aphasia and generalized seizures. A through workup excluded most causes of encephalopathy. He was, however, found to have TSH = 18.6 MIU/ml, T3reverse = 0.44nmol/L, T4 = 0.8ng/dl and Anti-Thyroid-Peroxidase AB titer >1000 IU/...

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Bibliographic Details
Main Authors: Robert Dobbin Chow, Nechama Bernhardt, Natallia Maroz
Format: Article
Language:English
Published: Greater Baltimore Medical Center 2012-04-01
Series:Journal of Community Hospital Internal Medicine Perspectives
Subjects:
Online Access:http://www.jchimp.net/index.php/jchimp/article/view/11453/pdf_1
Description
Summary:We herewith describe a patient with acute confusion, expressive aphasia and generalized seizures. A through workup excluded most causes of encephalopathy. He was, however, found to have TSH = 18.6 MIU/ml, T3reverse = 0.44nmol/L, T4 = 0.8ng/dl and Anti-Thyroid-Peroxidase AB titer >1000 IU/ml. Based on the above findings the patient was diagnosed with Hashimoto's encephalopathy and his mental status showed dramatic improvement (MMS 30/30) with high dose prednisone. Hashimoto's encephalopathy is rare disorder of presumed autoimmune origin characterized by cognitive decline, seizures, neuro-psychiatric symptoms, high titers of Anti-Thyroid-Peroxidase AB, and a positive response to steroids.
ISSN:2000-9666